Implant Dentistry

DENTAL SCIENCE, MATERIALS AND TECHNOLOGY
MCQ IN IMPLANT DENTISTRY
No part of this digital document may be reproduced, stored in a retrieval system or transmitted in any form or
by any means. The publisher has taken reasonable care in the preparation of this digital document, but makes no
expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No
liability is assumed for incidental or consequential damages in connection with or arising out of information
contained herein. This digital document is sold with the clear understanding that the publisher is not engaged in
rendering legal, medical or any other professional services.
DENTAL SCIENCE, MATERIALS
AND TECHNOLOGY
Additional books in this series can be found on Nova’s website

under the Series tab.
Additional e-books in this series can be found on Nova’s website

under the eBooks tab.
DENTAL SCIENCE, MATERIALS AND TECHNOLOGY
MCQ IN IMPLANT DENTISTRY
MOHAMMED JASIM AL-JUBOORI
New York
Copyright © 2016 by Nova Science Publishers, Inc.
All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted
in any form or by any means: electronic, electrostatic, magnetic, tape, mechanical photocopying,
recording or otherwise without the written permission of the Publisher.
We have partnered with Copyright Clearance Center to make it easy for you to obtain permissions to
reuse content from this publication. Simply navigate to this publication’s page on Nova’s website and
locate the “Get Permission” button below the title description. This button is linked directly to the
title’s permission page on copyright.com. Alternatively, you can visit copyright.com and search by title,
ISBN, or ISSN.
For further questions about using the service on copyright.com, please contact:
Copyright Clearance Center
Phone: +1-(978) 750-8400 Fax: +1-(978) 750-4470 E-mail: info@copyright.com.
NOTICE TO THE READER

The Publisher has taken reasonable care in the preparation of this book, but makes no expressed or
implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is
assumed for incidental or consequential damages in connection with or arising out of information
contained in this book. The Publisher shall not be liable for any special, consequential, or exemplary
damages resulting, in whole or in part, from the readers’ use of, or reliance upon, this material. Any
parts of this book based on government reports are so indicated and copyright is claimed for those parts
to the extent applicable to compilations of such works.
Independent verification should be sought for any data, advice or recommendations contained in this
book. In addition, no responsibility is assumed by the publisher for any injury and/or damage to persons
or property arising from any methods, products, instructions, ideas or otherwise contained in this
publication.
This publication is designed to provide accurate and authoritative information with regard to the subject
matter covered herein. It is sold with the clear understanding that the Publisher is not engaged in
rendering legal or any other professional services. If legal or any other expert assistance is required, the
services of a competent person should be sought. FROM A DECLARATION OF PARTICIPANTS
JOINTLY ADOPTED BY A COMMITTEE OF THE AMERICAN BAR ASSOCIATION AND A
COMMITTEE OF PUBLISHERS.
Additional color graphics may be available in the e-book version of this book.
Library of Congress Cataloging-in-Publication Data

Names: Jasim Al-Juboori, Mohammed, editor.
Title: MCQ in implant dentistry / editor, Mohammed Jasim Al-Juboori
(Alameria, Baghdad, Iraq).
Description: Hauppauge, New York: Nova Science Publisher's, Inc., [2016] |
Series: Dental science, materials and technology | Includes
bibliographical references and index.
Identifiers: LCCN 2016008519| ISBN 9781634846691 (hardcover) | ISBN
9781634849623 (ebook)
Subjects: LCSH: Dental implants--Examinations, questions, etc.
Classification: LCC RK667.I45 M37 2016 | DDC 617.6/93076--dc23 LC record available at http://lccn.loc.gov/2016008519
Published by Nova Science Publishers, Inc. † New York

To my beloved mother who sacrifice her life for us and
to my biggest supporters, my brother and sister
Special thanks to
Dr. Omar Farouq Tawfiq for his cooperation and assistance
CONTENTS
Preface ix
Section One: Basic Science 1
Chapter 1 Anatomy 3
Chapter 2 Physiology 19
Chapter 3 Histology 31
Chapter 4 Pharmacology 51
Chapter 5 Biology 65
Chapter 6 Radiology 81
Chapter 7 Miscellaneous 89
Section Two: Clinical Science 97
Chapter 8 Surgical 99
Chapter 9 Prosthetic 159
Chapter 10 Maintenance 207
Index 217
PREFACE
Coming from the need of MCQ book related to implant dentistry that can cover from
basic to clinical question. More than that the limited time of the candidate with busy schedule
dentist who wants to sit for credential exams. So the aim of this book is to help the candidate
for quick revision and guidance. We have tried to make this book as a reading guide for exam
preparation by providing a reference for the correct answer. References is documented from
high rank journal and sound research or literature review. In this book I have tried to give the
necessary information that can be extracted from the questions phrase or the answers. Many
universities now started the program of implant dentistry from postgraduate continuous
education to master degree level, as well as the individual bodies providing fellowship and
diplomat credential certificate. And most of these programs depend on MCQ type of question
to assess the level of knowledge of the candidate.
How to read this book? Actually there is only one correct answer or choice for the
question, sometime the choice of (e.g., all of the above, none of the above, or a&b) still
considered as one correct choice. The correct answer will be at the end of each chapter. The
reader should estimate the time during solving the question that may need 1.5 minutes for
each question to be answered.
The questions and answers are not coming from opinion and experience but from solid
and evidence based dentistry sources. This book would not replacing the text book and notes,
but rather than offering a guidance and quick revision. For my knowledge this is the first
MCQ book provide a suggested reading list to help the reader more.
Mohammed Jasim Al-Juboori BDS, MSc, AFAAID, FICOI, FADIA

x Mohammed Jasim Al-Juboori
Mohammed Jasim Al-Juboori, BDS, MSc, holds a master’s degree in dental

implantology, is an Associated Fellow of American Academy of Implant Dentistry, and
Fellow the International Congress of Oral Implantologists and American Dental Implant
Association. He was a Research Fellow in the University of Nagasaki, Japan 2014. He has
published more than 25 articles in peer-reviewed journals and has lectured nationally and
internationally on implant dentistry and oral surgery topics. He is editor on board in many
international journals. In addition to his responsibilities teaching in Al-Rafidian College,
periodontal department, Baghdad/Iraq, he is part time associated dentist in private practice
limited to implant dentistry.
SECTION ONE: BASIC SCIENCE
Chapter 1
ANATOMY
1- In cases of severe bleeding and lingual hematoma during the placement of the implant
in the lower incisor region, which artery do you think is injured:
a- submental
b- sublingual
c- inferior labial
d- transverse facial
e- mental
2- The path of the inferior dental canal inside the mandible is not straight and deviates
from the lingual to the buccal in the area of:
a- third molar tooth
b- second molar tooth
c- second premolar tooth
d- first molar tooth
e- none of the above
3- Implant placed in front of the mental foramen should be 6 mm from the foramen to
prevent the encroachment of:
a- mental foramen
b- submental artery
c- anterior loop of the inferior dental nerve
d- incisive canal
e- b&c
4- During the procedure of autogenous bone grafting harvested from the area of
symphysis, dysesthesia can occur because:
a- damaging to the lower incisior teeth
b- muscle detachment during flap raise
c- incisive nerve damage
d- hematoma formation postoperatively
e- oedema formation postoperatively
4 Mohammed Jasim Al-Juboori
5- Severe bleeding and lingual hematoma that occur during implant placement in the
lower premolar area can be caused by severing the artery of:
a- lingual
b- submental artery
c- inferior alveolar artery
d- long buccal
6- “Witch Chin” is a postoperative complication that occurs when a mucoperiosteal flap

is raised in the symphyseal area because of:
a- injury to the orbicularis oris
b- detachment of mentalis muscle
d- periosteal striping
e- detachment of the platysma muscle
7- At an early age, the mandible blood supply is central, but over time, the blood supply
becomes peripheral:
a- inferior alveolar artery
b- lingual artery
c- endosteum
d- periosteum and attached muscle
e- mucosa
8- Inferior alveolar nerves are usually confined to the inferior canal but % are not
confined and are distributed throughout the mandible in areas such as the plexus:
a- 20%
b- 40%
c- 60%
d- 5%
e- 80%
9- The changes that occur in the incisive canal after tooth extraction include:
a- shortening and enlargement
b- shortening and narrowing
c- elongation and enlargement
d- elongation and narrowing
e- obliteration
10- A mean distance between the mandibular canal and the inferior mandibular border
measures approximately at:
a- 10 mm
b- 13mm
c- 8mm
d- 14mm
e- 6mm
Anatomy 5
11- The incisive nerve is innervate:

a- lateral and central incisor
b- canine, lateral and central incisor
c- first bicuspid, canine, lateral and central incisors
d- canine and lateral incisor
e- central incisor
12- The anterior loop of an inferior dental nerve can be predicted when the nerve comes:
a- above the mental foramen
b- below the mental foramen
c- above the mental foramen
d- same level with the mental foramen
e- disappear before the mental foramen
13- During implant placement and nerve injury, patients will feel numbness only when
the injured nerve supply:
a- soft tissue
b- bony tissue
c- teeth
d- muscular tissue
e- b& c
14- Dentoalveolar innervation and the periodontal ligament area of the innervation are:
a- nerve endings with nociceptors
b- sympathetic
c- parasympathetic
d- nerve endings with mechanoreceptors
e- a&b
15- Incisions on the buccal vestibules may cause severe edema and postoperative pain
due to:
a- incision on loose tissue
b- plexus of blood vessels found in the vestibule
c- incision in non keratinized tissue
d- poor lymphatic drainage in this area
e- all of the above
16- The length of the inferior alveolar nerve’s anterior loop is:
a- <3 mm
b- <5 mm
c- <6 mm
d- <7 mm
e- 8mm
17- The use of a probe to clinically identify the anterior loop has been suggested;
however, the drawback of this procedure is:
a- not possible to differentiate between an anterior loop and an incisive canal
b- difficult for the probe to go full length
c- trauma to the mental nerve
d- mental foramen angulation is different from the anterior loop
e- all of the above
18- The periosteum and both the lateral wall of the maxillary sinus and its Schneiderian
membrane are supplied by two arterial branches:
a- middle and posterior superior alveolar artery
b- anterior and middle superior alveolar artery
c- posterior superior alveolar artery and the infraorbital artery
d- posterior superior and greater palatin artery
19- The lateral wall of the maxillary sinus hosts the superior alveolar canal:
a- branches of the posterior superior alveolar and infraorbital arteries
b- branches of posterior and middle superior alveolar arteries
c- branches of posterior superior alveolar arteries only
d- branches of middle superior and infraorbital arteries
e- branches of posterior superior and greater palatine artery
20- The inferior border of the mandible receives most of its blood supply from:
a- periosteum
b- inferior alveolar artery
c- muscle attachment
d- mucosa
e- a&d
21- The gingiva and periosteum receive their blood supply mainly through the
supraperiosteal vessels, which run ____________________ to the long axis of the teeth:
a- angular
b- perpendicular
c- parallel
d- circular
e- a&b
22- The vascular network within the periosteum and the periodontal plexus communicate
directly via:
a- Volkmann’s canals
b- Haversian canals
c- Intraseptal plexus
d- Bone marrow plexus
e- c&d
Anatomy 7
23- The human temporomandibular joint is essentially a double joint due to:
a- both joint found on the mandible
b- presence of an intra- articular disc
c- both joint innervated and function in the same time
d- has two movement (hinge and sliding)
e- a&c
24- In the temporomandibular joint, the receptors are primarily free nerve endings, and
the receptors are either mechanoreceptive, detecting stretch and pressure, or nociceptive,
detecting:
a- tissue damage or threat of damage
b- posture and position
c- pain
d- pressure
e- movement
25- When the temporomandibular joint is at rest, the mandible adopts the so- called rest
position. The condyle occupies a ____________________ and ____________________
position in the glenoid fossae with upper and lower teeth separated:
a- central and unstrained
b- posterior and unstrained
c- anterior and unstrained
d- central and strained
26- Simple jaw opening muscles, which are responsible for producing a rotation of the
condylar head, include the digastric (anterior belly), mylohyoid and geniohyoid muscles. The
action of these muscles can only be achieved if:
a- rotation of meniscus disc anteriorly
b- relaxation of the sling muscle (pterygomasseteric)
c- contraction of the anterior fibres of temporalis muscle
d- infrahyoid muscle stabilise the hyoid bone
e- contraction of the posterior fiber of temporalis muscle
27- translation movement of the condylar head onto the articular eminence during jaw
opening is achieved through the action of:
a- anterior belly of diagastric
b- medial pterygoid muscle
c- lateral pterygoid muscle
d- geniohyoid muscle
e- omohyoid muscle
28- The middle portion of the Schneiderian membrane’s blood supply from:
a- greater palatin artery
b- posterior superior alveolar artery
c- infra orbital artery
d- middle superior alveolar artery
29- Nerve fibers in dentate jawbone are usually limited to:

a- periodontium
b- cortical bone
c- bone marrow
d- canceloous bone
e- b&d
30- The lingual nerve provides a sensory supply to the:

a- lingual aspect of the mucosa, mandibular incisiors, anterior 2/3 of the tongue
b- lingual aspect of the mucosa, floor of the mouth, posterior 2/3 of the tongue
c- lingual aspect of the mucosa, floor of the mouth, lateral border of the tongue
d- lingual aspect of the mucosa, floor of the mouth, anterior 2/3 of the tongue
31- The motor innervation of the mylohyoid and anterior belly of the digastric muscles
through:
a- motor branch of the lingual nerve
b- motor branch of the inferior dental nerve
c- chorda tympani branch of the facial nerve
d- hypoglossal nerve
e- glossopharyngeal nerve
32- The sensory innervation of the skin and mucous membranes of the lower lip:
a- mental nerve
b- incisive nerve
c- buccal branch of the facial nerve
d- long buccal
e- b&c
33- Taste receptors are predominantly located on the dorsum of the tongue and also on:
a- soft palate
b- epiglottis
c- pharyngeal wall
d- a & c
e- all of the above
Anatomy 9
34- Taste sensation is perceived directly in the cortex, and the nerve fibers subserving the
function of taste are:
a- sensory
b- sympathetic
c- parasympathetic
d- proprioceptive
35- The palatoglossus muscle enters the side and the dorsum of the tongue, acts as a
retractor to the root of the tongue, and work with its partner on the other side to:
a- depress the soft palate
b- elevate the tongue
c- depress the tongue
d- narrowing the oropharyngeal opening
e- elevate the soft palate
36- Regarding the temporomandibular joint articular disc, the main loading area and the
potential area of perforation are:
a- lateral aspect of the disc
b- medial aspect of the disc
c- posterior area of the disc
d- anterior area of the disc
37- Regarding the temporomandibular joint articular disc, during mouth closure, the
anterior part of the disc is located:
a- just anterior to the condyle
b- along the articular eminence
c- superior to the condyle
d- along the articular tubercle
38- The temporomandibular (lateral) ligament is a thickened ligament on the lateral

aspect of the capsule and acts as:
a- limiting the posterior movement of the articular disc
b- limiting the posterior movement of the condyle
c- limiting the protrusion movement of the mandible
d- limiting the protrusion movement of the mandible
e- a&b
39- Nasal bleeding is often due to trauma to the:

a- septal branch of the superior labial artery from the ophthalmic artery
b- septal branch of the superior labial artery from the facial artery
c- septal branch of the superior labial artery from the maxillary artery
d- external nasal artery from the maxillary artery
40- The middle meatus of the middle conchae drains the following structure:
a- posterior ethmoidal sinus
b- sphenoidal sinus
c- nasolacrimal duct
d- superior conchae
41- Each muscle of the soft palate has a special function; for example, the levator veli
palatini muscle will act as:
a- pull the soft palate laterally
b- elevates uvula
c- elevate and pull the soft posteriorly
d- elevate the pharynx and larynx
e- a&b
42- All muscles of the soft palate innervated by pharyngeal plexus (motor part of the
vagus + cranial part of the accessory nerve) except one, which is innervated by the muscular
branch of the mandibular nerve. This muscle is:
a- tensor veli palatine
b- musculus uvulae
c- levator veli palatini
d- palatoglossus
43- All of the following veins drain into the pterygoid plexus except:
a- inferior alveolar vein
b- sphenopalatine
c- anterior superior alveolar vein
d- lesser palatine vein
e- lingual vein
44- Some structures and veins have connections to the cavernous sinus, such as:
a- pterygoid plexus
b- facial veins (valveless)
c- submental vein
d- internal jagular
e- a&b
45- The greater palatine nerve innervates:

a- the soft palate
b- palatal gingiva from the premolars to the premaxilla
c- palatal gingiva from the posterior border of the hard palate to the first molar
d- palatal gingiva from second premolar to the canine
Anatomy 11
46- A Submandibular space infection can spread into:

a- sublingual space
b- lateral pharyngeal space
c- peritonsillar space
d- retropharyngeal space
e- a&b
47- Infections in the lower molar teeth usually spread into the submandibular space due
to:
a- thin lingual plate
b- the roots curved lingually
c- the roots located above the attachment of the mylohyoid muscle
d- thick cervical facial direct the infection toward the submandibular space
48- An infection from the retropharyngeal space can spread into the thorax (diaphragm)
through:
a- danger space
b- prevertebral space
c- carotid sheath
d- pretreacheal space
e- a&b
49- An anesthesia block to the long buccal nerve will anesthetize:

a- cheek mucosa
b- retromolar region
c- retromolar region and the buccal gingiva of the mandibular molars and premolars
d- retromolar region and the buccal gingiva of the mandibular molars
e- a&c
50- During mental nerve block anesthesia, the following structure is anesthetized:
a- buccal gingiva and mucosa from premolars to the midline
b- skin of the lower lip
c- lower anterior teeth
d- lower bicuspid teeth
e- a&b
51- 3% of the jaw has distinct lingual depressions to house the lingual gland, and
perforation of the lingual plate in this area will cause severe bleeding when the implant is
placed in the area:
a- between central incisor and canine
b- bicuspid
c- between lateral incisor and second premolar
d- between central incisor and first premolar
52- Mandibular teeth in the natural dentition are_________ inclined in relation to the
mandibular base:
a- lingually
b- buccally
c- distally
d- mesially
e- b&d
53- Based on the mandibular foramen level in the occlusal plan, the inferior alveolar
block should be administered at:
a- the occlusal level
b- 6mm above the occlusal level
c- 2mm below the occlusal level
d- 2mm above the occlusal level
54- During an inferior alveolar block, the molar teeth may still be symptomatic. If this is
the case, lingual infiltration is recommended due to additional innervation from:
a- chorda tympani nerve
b- mylohyoid nerve
c- hypoglossal nerve
d- C2 and C3 (cutaneous coli nerve of the cervical plexus)
e- a&c
55- fFor more bone- implant engagement and better stability during the immediate
implant placement period in the upper anterior teeth:
a- the palatal bone is thick and shallow palatal vault
b- the palatal bone is thin and high palatal vault
c- the palatal bone is thick and high palatal vault
d- the palatal bone is thin and shallow palatal vault
CORRECT ANSWERS
Q1
b- sublingual
Q2
d- first molar tooth
Q3
c- anterior loop of the inferior dental nerve
Q4
Anatomy 13
Q5
b- submental artery
Q6
b- detachment of mentalis muscle
Q7
d- periosteum and attached muscle
Q8
b- 40% (Olivier E. The inferior dental canal and its nerve in the adult. Br Dent J. 1928
49:356 –358.)
Q9
a- shortening and enlargement
Q10
a- 10 mm
Q11
c- first bicuspid, canine, lateral and central incisors
Q12
b- below the mental foramen
Q13
a- soft tissue
Q14
c- parasympathetic (no evidence of its existence)
Q15
b- plesxus of blood vessels
Q16
a- <3 mm
Q17
a- not possible to differentiate between an anterior loop and an incisive canal
Q18
c- posterior superior alveolar artery and the infraorbital artery
Q19
a- branches of the posterior superior alveolar and infraorbital arteries
Q20
b- inferior alveolar artery
Q21
c- parallel
Q22
a- Volkmann’s canals
Q23
b- presence of an intra- articular disc
Q24
a- tissue damage or threat of damage
Q25
Q26
Q27
Q28
e- none of the above (sphenopalatin artery)
Q29
a- periodontium
Q30
d- lingual aspect of the mucosa, floor of the mouth, anterior 2/3 of the tongue
Q31
b- motor branch of the inferior dental nerve
Q32
a- mental nerve
Q33
e- all of the above
Q34
c- parasympathetic
Anatomy 15
Q35
d- narrowing the oropharyngeal opening
Q36
a- lateral aspect of the disc
Q37
a- just anterior to the condyle
Q38
e- a&b
Q39
b- septal branch of the superior labial artery from the facial artery
Q40
e- none of the above (anterior ethmoidal sinus, middle ethmoidal sinus, maxillary sinus,
frontal sinus)
Q41
c- elevate and pull the soft posteriorly
Q42
a- tensor veli palatine
Q43
e- lingual vein
Q44
e- a&b
Q45
e- none of the above (palatal gingiva from the posterior border of the hard palate to the
first premolar)
Q46
e- a&b (continue with sublingual along the posterior border of the mylohyoid muscle)
Q47
e- none of the above (the roots located below the attachment of the mylohyoid muscle)
Q48
a- danger space (posterior to the alar fascia and anterior to the prevertebral fascia, extend
from the base of the skull to the diaphragm)
Q49
d- retromolar region and the buccal gingiva of the mandibular molars
Q50
e- a&b
Q51
c- between lateral incisor and second premolar
Q52
a- lingually
Q53
b- 6mm above the occlusal level
Q54
d- C2 and C3 (cutaneous coli nerve of the cervical plexus)
Q55
a- the palatal bone is thick and shallow palatal vault
REFERENCES
Apostolakis D, Bissoon AK. Radiographic evaluation of the superior alveolar canal:
Measurements of its diameter and of its position in relation to the maxillary sinus floor: a
cone beam computerized tomography study. Clin Oral Impl Res. 2014;25:553–559.
Apostolakis D, Brown JE. The anterior loop of the inferior alveolar nerve: prevalence,
measurement of its length and a recommendation for interforaminal implant installation
based on cone beam CT imaging. Clin Oral Impl Res 2012;23:1022–1030.
Castelli W Vascular architecture of the human adult mandible. J dent Res 1963;42:786–92.
Ferguson DB oral bioscience, Chrchill Livingstone, Edinburgh, 1999.
Folke LE, Stallard RE. Periodontal microcirculation as revealed by plastic microspheres. J
Periodontal Res 1967;2:53–63.
Greenstein, G. & Tarnow, D. The mental foramen and nerve: clinical and anatomical factors
related to dental implant placement: a literature review. J Periodontol 2006;77:1933–
1943.
Hur, M.S., Kim, J.K., Hu, K.S., Bae, H.K., Park, H.S. & Kim, H.J. Clinical implications of
the topography and distribution of the posterior superior alveolar artery. J Craniofaci
Surg 2009;20: 551–554.
Keller GJ, Cohen DW. India ink perfusions of the vascular plexus of oral tissues. J Oral Surg
(Chic) 1955;8:539–42.
Liang X, Jacobs R, Martens W, et al. Macro- and micro-anatomical, histological and
computed tomography scan characterization of the nasopalatine canal. J Clin Periodontol
2009;36:598–603.
Anatomy 17
Malamed SF. Handbook of local anaesthesia. St louis: Mosby, 1986:183–193.

Mardinger O, Namani-Sadan N, Chaushu G, Schwartz-Arad D. Morphologic changes of the
nasopalatine canal related to dental implantation: A radiologic study in different degrees
of absorbed maxillae. J Periodontol 2008;79:1659–1662.
Mckay GS, Yemm R, Cadden SW the structure and function of the temporpmandibular joint
Br Dent J 1992;173:127.
Misch CE. Contemporary Implant Dentistry. St Louis, Mo: Mosby-Year Book; 3rd edition,
2008.
Neil s. Norton Netter’s head and neck anatomy for dentistry, 2nd edition, Elsever,
Philadelphia, 2012.
Nobuto T, Yanagihara K, Teranishi Y, Minamibayashi S, Imai H, Yamaoka A. Periosteal
microvasculature in the dog alveolar process. J Periodontol 1989;60:709–15.
Nobuto T, Yanagihara K, Teranishi Y, Minamibayashi S, Imai H, Yamaoka A. Periosteal
microvasculature in the dog alveolar process. J Periodontol 1989;60:709–15.
Olivier E. The inferior dental canal and its nerve in the adult. Br Dent J. 1928 49:356–358.
Rajchel J, Ellis E 3rd, Fonseca RJ. The anatomical location of the mandibular canal: its
relationship to the sagittal ramus osteotomy. Int J Adult Orthodon Orthognath Surg
1986;1:37–47.
Solar P, Geyerhofer U, Traxler H, Windisch A, Ulm C, Watzek G., blood supply to the
maxillary sinus relevant to sinus floor elevation procedure, Clin Oral Implants Res
1999;10:34–44.
Solar, P., Geyerhofer, U., Traxler, H., Windisch, A., Ulm, C. & Watzek, G. Blood supply to
the maxillary sinus relevant to sinus floor elevation procedures. Clin. Oral Impl Res
1999;10:34–44.
Williams PL, Warwick R. Gray’s Anatomy. 36th ed. Edinburgh: Churchill Livingstone;
1980:1281–1287.
Yoshida, S., Kawai, T., Asaumi, R., Miwa, Y., Imura, K., Koseki, H., Sunohara, M., Yosue,
T. & Sato, I. Evaluation of the blood and nerve supply patterns in the molar region of the
maxillary sinus in Japanese cadavers. Okajimas Folia Anatomica Japonica 2010;87:129–
133.
Chapter 2
PHYSIOLOGY
1- In a fully edentulous mandible, connecting posterior implants on both sides with one
prosthesis is contraindicated because of:
a- phonetic problem (limited tongue space)
b- torsion of the mandible distal to the mental foramen
c- difficult to lingulize the prosthesis, that lead to cross bit occlusion
d- path of prosthesis insertion would be impossible
e- b&c
2- During maxillary sinus augmentation, the Schneiderian membrane is susceptible to

perforation during elevation, but the risk decreases when the membrane:
a- thickness 1.5 - 2mm
b- thickness 0.5- 3mm
c- thickness 0.6- 2mm
d- none of the above
3- Perforation of the Schneiderian membrane (mean thickness: 90 μm) occurs at a mean

tension of:
a- 7.3 N/mm2
b- 20.5 N/mm2
c- 15.3 N/mm2
d- 31.4 N/mm2
4- Patients with cardiovascular disease should be treated with:

a- supine position
b- upright position
c- semisupine position
5- After tooth extraction, all of the following are true except:

a- 25% of the alveolar bone width decrease during the first year
b- bone loss in mandible is fourfold greater than maxilla
c- bone height decrease into 6 mm in the first year
d- bone loss would be more in multiple adjacent teeth extraction
6- In severe resorption of the mandible, the fate of the mental foramen is:
a- located upward near the upper border
b- obliterated
c- seclerotic
d- enlarge in size
e- c&d
7- The resting interocclusal distance (freeway space) can be affected by:

a- psychological state
b- body posture
c- fatigue
d- all of the above
8- Following speech, mastication, or swallowing, the mandible appears to return to:

a- centric occlusion
b- centric relation
c- protrosion position
9- Some submucosal tissues act as a cushion during compressive loading, such as:
a- myxiod tissue
b- salivary gland
c- adipose tissue
d- all of the above
10- The touch threshold in normal natural teeth can distinguish objects within 0.2 mm,
but this threshold is affected by:
a- malocclusion
b- denture wearers
c- anaesthesia
d- large force during mastication
e- all of the above
11- Lateral movement of the mandible is accompanied by lateral translation of the

condyle on the same side of up to 1.4 mm. This movement is called:
a- hinge movement
b- excursion movement
c- translation movement
d- Bennett movement
Physiology 21
12- During mastication, we use the temporalis muscle for quick closure and gentle biting,
while for more powerful crushing, we use:
a- medial pterygoid muscle
b- masseter muscle
d- infra hyoid muscles
e- a & b
13- The biting force among young people with natural teeth indicates that in the first
molar, the greatest biting force is approximately:
a- 30 kilo
b- 70 kilo
c- 45 kilo
d- 100 kilo
14- The temporomandibular joint is technically classified as a ginglymoarthrodial

articulation, which by definition is:
a- originated from cartilagenous and membraneous type of bone
b- capable of hinge and sliding type of movement
c- articulation between the mandible and temporal bone
15- The temporomandibular joint is considered a non- weight- bearing joint because of 2
factors: the force of mastication transmitted via the teeth and periodontium to the maxilla and
mandible and the:
a- joint supported by sling of jaw muscles
b- high elasticity of muscle of mastication
c- long fulcrum arm of the mandible
d- force are dispersed to the buttresses and pterygoind plate
e- all of the above
16- The temporomandibular joint is supported by a sling muscle, which comprises

_________________ and is counteracted by ____________________ . This has the effect of
locating the head of the condyle in a low- stress relationship with the glenoid fossa:
a- anterior belly of diagasteric muscle counteracted by pterygomasseteric complex
b- anterior fibres of temporalis muscle counteracted by pterygomasseteric complex
c- posterior fibres of temporalis muscle counteracted by pterygomasseteric complex
d- infrahyoid muscle counteracted by pterygomasseteric complex
17- In dentoalveolar gingival tissue, the direction of the blood supply is mainly from the
vestibule to the gingival margin. The circulation changes that were observed suggest that
flaps receive their primary blood supply from their apical aspect. The circulatory disturbance
is greater when:
a- greater the ratio of flap length to base
b- greater the ratio of flap base to length
c- full thickness flap raised
d- oblique vertical incision included in the flap
18- Many factors can increase ↑or decrease↓ the salivary flow rate, such as:
a- dehydration ↓, patient standing ↑, smoking ↑, sleeping ↓, darkness ↑
b- dehydration ↓, patient standing ↓, smoking ↑, sleeping ↓, darkness ↓
c- dehydration ↓, patient standing ↑, smoking ↓, sleeping ↑, darkness ↓
d- dehydration ↓, patient standing ↑, smoking ↑, sleeping ↓, darkness ↓
19- Factors affecting salivary composition, such as:

a- flow rate
b- contribution of different salivary glands
c- duration of stimulus
d- nature of stimulus
e- all of the above
20- The contributions of different salivary glands secretion into the oral cavity include:
a- parotid 20%, submandibular 65%, sublingual 7- 8%, minor glands 7- 8%
b- parotid 30%, submandibular 55%, sublingual 7- 8%, minor glands 7- 8%
c- parotid 40%, submandibular 50%, sublingual 7- 8%, minor glands 2- 3%
d- parotid 50%, submandibular 40%, sublingual 7- 8%, minor glands 2- 3%
21- At a high flow rate of salivation, the following salivary gland becomes the dominant
gland and contributes approximately 50% of the entire salivary secretion:
a- sublingual
b- submnadibular
c- parotid
d- palatal minor salivary gland
22- The mechanical properties in the cortical bone of the mandible are anisotropic, which
is related to the orientation of:
a- osteon
b- collagen fibers
c- muscle attachment
d- trabicular bone
e- a&c
Physiology 23
23- The modulus elasticity of the cortical bone of the mandible decrease gradually as the
orientation of the load changes, and the maximum value of the modulus occurs at:
a- 0°
b- 90°
c- 45°
d- 70°
24- It is important to consider anatomical aspects in the modulus elasticity of the cortical
bone of the mandible because there can be a decrease or increase in the modulus value in:
a- dental foramen (decrease)
b- muscle attachment (reinforcements)
c- fossae (decrese)
d- all of the above
25- Peri- and postoperative gingival blood flow is affected by:

a- anesthesic containing a vasoconstrictor
b- smoking
c- periosteal disruption
d- all of the above
26- In the maxillary jaw, the blood supply is permanently reduced with age, which may
be due to:
a- microvascular defect
b- stenotic changes
c- reduction of the intramedullary flow
d- all of the above
27- a Decreasing blood supply with age will lead to maxillary jaw atrophy through:
a- inhibition of the osteoblastic activity
b- delay in bone mineralization
c- reduction in cancellous bone
d- all of the above
28- Bones respond to physiologic stress by:

a- bone resorption
b- bone remodelling
c- bone formation
d- soft tissue formation
e- c&d
29- Osteoclast cells can cause bone resorption by dissolving the apatite crystals and
digesting collagen fiber, which can be achieved by:
a- organic acids
b- metalloproteinases
c- collagenase
d- all of the above
30- at maximum smile, there will be decrease in upper lip length compared to the rest
position of approximately:
a- 40%
b- 20%
c- 30%
d- 10%
e- 50%
31- The maximum tolerable temperature in the mouth ranges from:

a- 70- 80°C
b- 80- 90°C
c- 90- 100°C
d- 60- 70°C
32- The area of the tongue innervated by the facial nerve fibers responds to sweet, salt
and acid, while the posterior area of the oral cavity, which is innervated by fibers of the
glossopharyngeal and vagus nerves, responds to the taste of:
a- acid
b- bitter
c- sweet
d- salt
e- a&c
33- The fiber types found in the muscles of mastication, which are type I, are appropriate
for producing:
a- slow movement without fatiguing
b- powerful forces with easy fatiguing
c- powerful forces without fatiguing
d- fast movement with easy fatiguing
34- The depression movement of the mandible occurs more rapidly than the elevation
movement, which is due to:
a- type IIA and IIB muscle in the anterior belly of diagastric
b- type I muscle in the anterior belly of diagastric
c- type IIA and IIB muscle in the mylohyoid muscle
d- type IIA muscle in massetric and medial ptrygoid muscle
Physiology 25
35- During hard clenching of the teeth, the following muscle is active:
a- geniohyoid
b- sternocleidomastoid
c- omohyoid
d- thyrohyoid
e- a&c
36- Static force, which can be produced in the molar region, is approximately 440 N and
declines to--------------- N in the canine region:
a- 150N
b- 250N
c- 350N
d- 80N
e- 100 N
37- The subject has been observed to swallow approximately 600 times in 24 hour, but
during sleep, the swallowing frequency drops to approximately:
a- 80 times in hour
b- 6 times in hour
c- 50 times in hour
d- 20 times in hour
e- 15 times in hour
38- Women have higher voice frequencies than men, which is related to:
a- force of expiration
b- number of the vocal cords
c- length of the vocal cords
d- thickness of the vocal cords
e- b&d
39- loudness of sound relates primarily to the:

b- lyrnx muscle strength
c- resonance in the maxillary sinus
d- bony conduction
40- Any alteration in the fitting of a denture will affect in the quality of speech,
particularly the sounds of:
a- ‘s’
b- ‘f’
c- ‘th’
d- ‘m’
e- a&b
41- After extraction of a tooth with thin bone phenotypes, the following changes will
occur during the 8- week healing period:
a- decrease facial soft tissue thickness, mid- facial horizontal bone loss of more than 20%
b- increase facial soft tissue thickness, mid- facial vertical bone loss of more than 50%
c- increase facial soft tissue thickness, mid- facial horizontal bone loss of more than 20%
d- facial soft tissue thickness maintained, mid- facial horizontal bone loss of more than
40%
42- Immediate implant placement in the upper anterior socket with more than 1 mm
labial bone thickness will lead into:
a- resorption of the labial bone occurs and a flat ridge develops
b- portion of the labial bone does not resorb and the ridge shape is maintained
c- no resorption occur and the ridge maintain the profile
d- horizantal and vertical bone resorption occur with gingival recession
CORRECT ANSWERS
Q1
b- torsion of the mandible distal to the mental foramen
Q2
a- thickness 1.5 - 2mm
Q3
a- 7.3 N/mm2
Q4
c- semisupine position
Q5
c- bone height decrease into 6 mm in the first year
Q6
a- located upward near the upper border
Q7
d- all of the above
Q8
d- none of the above (rest position)
Q9
d- all of the above
Physiology 27
Q10
e- all of the above
Q11
d- Bennett movement
Q12
e- a & b
Q13
c- 45 kilo (other molar slightly less, premolar and incisors only one third of molar)
Q14
b- capable of hinge and sliding type of movement
Q15
a- joint supported by sling of jaw muscles
Q16
c- posterior fibres of temporalis muscle counteracted by pterygomasseteric complex
Q17
a- greater the ratio of flap length to base
Q18
d- dehydration ↓, patient standing ↑, smoking ↑, sleeping ↓, darkness ↓ (royal college)
Q19
e- all of the above
Q20
a- parotid 20%, submandibular 65%, sublingual 7- 8%, minor glands 7- 8%
Q21
c- parotid
Q22
b- collagen fibers
Q23
a- 0° (because of the mandible anisotropic properties)
Q24
d- all of the above (because of the mandible anisotropic properties)
Q25
d- all of the above
Q26
d- all of the above
Q27
d- all of the above
Q28
b- bone remodelling
Q29
d- all of the above
Q30
c- 30%
Q31
a- 70- 80°C
Q32
b- bitter
Q33
c- powerful forces without fatiguing
Q34
a- type IIA and IIB muscle in the anterior belly of diagastric
Q35
b- sternocleidomastoid
Q36
a- 150N
Q37
b- 6 times in hour
Q38
c- length of the vocal cords (shorter in women 7- 11mm in women, to 15mm in men)
Q39
Physiology 29
Q40
e- a&b
Q41
b- increase facial soft tissue thickness, mid- facial vertical bone loss of more than 50%
Q42
b- portion of the labial bone does not resorb and the ridge shape is maintained
REFERENCES
Ambrosini P, Cherene S, Miller N, Weissenbach M, Penaud J. A laser Doppler study of
gingival blood flow variations following periosteal stimulation. J Clin Periodontol
2002;29:103–7.
Brekhus PJ other molar slightly less, premolar and incisors only one third of molar The
deterioration of human teeth. J Am Dent Assoc 1951;42:424–7.
Burkhardt R, Kettner G, Böhm W, Schmidmeier M, Schlag R, Frisch B, Mallmann B,
Eisenmenger W, Gilg TChanges in trabecular bone, hematopoiesis and bone marrow
vessels in aplastic anemia, primary osteoporosis, and old age: a comparative
histomorphometric study. Bone 1987;8:157–64.
Chappuis V, Engel O, Shahim K, Reyes M, Katsaros C, Buser D Soft Tissue Alterations in
Esthetic Postextraction Sites: A 3-Dimensional Analysis. J Dent Res. 2015;94(9
Suppl):187S–93S.
Edgar WM Saliva and dental health. Clinical implications of saliva: report of a consensus
meeting. Br Dent J 1990;25:96–8.
Ferguson DB Oral Bioscience, Chrchill Livingstone, 1999.
Ketabi, M. & Hirsch, R. S. The effects of local anesthesic containing adrenaline on blood
flow in smokers and non-smokers. J Clin Periodontol 1997;24:888–892.
Kobayashi S; Nihon Seikeigeka Gakkai Zasshi. Bone atrophy in rheumatoid arthritis a
morphological and histometrical study of proximal tibial condyles 1982;56:727–38.
Lettry S, Seedhom BB, Berry E, Cuppon M Quality assessment of the cortical bone of the
human mandible. Bone 2003;32:35–44.
McGregor AD1, MacDonald DG Age changes in the human inferior alveolar artery-a
histological study. Br J Oral Maxillofac Surg 1989;27:371–4.
Mckay GS, Yemm R, Cadden SW the structure and function of the temporpmandibular joint.
Br Dent J 1992;173:127.
Mörmann W, Ciancio SG. Blood supply of human gingiva following periodontal surgery. A
fluorescein angiographic study. J Periodontol 1977;48: 681–92.
Öwall B & Möller E. tactile sensibility during chewing and biting Odont Revy 1974;25:327.
Öwall B. oral tactility during chewing II. Natural dentition. Odent Revy 1974;25:135.
Pedlar J Histological localization of myxoid tissue in normal human palatal mucosa and its
glycosaminoglycans. Arch Oral Boil 1987;32:195–199.
Pommer B, Unger E, Sütö D, Hack N, Watzek G. Mechanical properties of the Schneiderian
membrane in vitro. Clin Oral Implants Res 2009;20:633–637.
Preiskel H Observations on Bennett movement. Dent Pract Dent Rec 1972;22:179–85.

Preiskel HW Ultrasonic measurements of movements of the working condyle. J Prosthet
Dent 1972;27:607–15.
Roe P, Rungcharassaeng K, Kan J, Patel RD, Campagni WV, Brudvik JS the influence of
upper lip length and lip mobility on maxillary incisor exposure. Am J Esthetic Dent
2012,2:116–25.
Wen SC, Lin YH, Yang YC, Wang HL. The influence of sinus membrane thickness upon
membrane perforation during transcrestal sinus lift procedure. Clin Oral Implants Res.
2014;29.
Chapter 3
HISTOLOGY
1- The main differences in periodontium between natural teeth and dental implants are:
a- collagen fibers non- attached to the dental implant and run parallel to the implant
surface
b- collagen fiber non- attached to the dental implant and run perpendicular to the implant
surface
c- collagen fiber non- attached to the dental implant and run oblique to the implant
surface
d- collagen fiber attached to the dental implant and run perpendicular to the implant
surface
2- The biological width in cases with natural teeth is measured as:

a- junctional epithelium attachment 0.97mm connective tissue attachment of 1.07mm or
in sum approximately 2.5 mm
b- junctional epithelium attachment 1.02mm connective tissue attachment of 1.0mm or in
sum approximately 2 mm
c- junctional epithelium attachment 0.97mm, connective tissue attachment of 1.07mm or
in sum approximately 2mm
d- junctional epithelium attachment 0.87mm connective tissue attachment of 1.3mm or in
sum approximately 2mm
3- After tooth extraction, the buccal bone plate is subjected to dramatic resorption
compared to the lingual plate due to:
a- mainly canceleous bone
b- thin plate more subjected to be fracture during extraction
c- has less blood supply
d- usually ankylosed to the tooth
e- c&d
4- The basal lamina attaches the epithelium to the underlying connective tissue through:
a- hemidesmosomes
b- desmosomes
c- microfilament
d- microtubules
e- intermediate filaments
5- The basal lamina between the epithelium and the connective tissue functions as:
a- filter the passage of the molecules
b- barrier to cell migration
c- signalling function
d- all of above
6- The main components of the basal lamina are:

a- type I collagen
b- type II collagen
c- type IV collagen
d- type III collagen
7- Motility and contractility are important during connective tissue formation and wound
repair, in which the role of:
a- myofilamant
b- fibroblast cells
c- epithelial cells
d- fibrous tissue
e- collagen
8- The major producers of collagen are mesenchymal cells and their derivatives, which
are:
a- fibroblast
b- osteoblast
c- chondrocyte
d- cementoblast
e- all of above
9- Bones resist forces applied along the axis of their fibrous tissue component, and
therefore, bone fractures occur because:
a- tensile and slicing stresses
b- compressive forces
c- cycling forces
d- high impact forces
e- b&c
Histology 33
10- Bone is a mineralized connective tissue comprising collagen by weight, 28% type:
a- IV collagen
b- II collagen
c- I collagen
d- Type III collagen
11- Osteon is a type of cylindrical bone comprising:

a- Haversian canal
b- bone cells lining
c- capillaries
d- all of above
12- Periosteum includes an outer fibrous layer and an inner layer next to the bone surface
comprising:
a- bone cells, precursors cells, blood vessels
b- fibrous tissue and blood vessels
c- bone cells and blood vessels
d- bone cells and fibrous tissue
e- dense fibrous tissue, bone cells and blood vessels
13- Osteoblasts are bone- forming cells that can synthesize:

a- collagenous bone matrix protein
b- noncollagenous bone matrix protein
c- collagenous and noncollagenous bone matrix protein
d- hadroxyapetite crystals
14- Osteoid is:

a- mainly mineral crystals that embedded inside bone scaffold
b- mainly collagen that act as a scaffold
c- collagen and blood vessels that act as a scaffold
d- combination of the collagen and mineral crystals that form the smallest unite of bone
15- Noncollagenous proteins secreted from osteoblasts regulate the mineral deposition:
a- bone sialoprotein
b- osteopontin
c- calcitonin
d- a&b
e- b&c
16- The most important hormones in bone metabolism are:

a- parathyroid hormone
b- 1,25- dihydroxyvitamine D
c- calcitonin
d- estrogen
e- all of the above
17- The number of osteoblasts that become osteocytes varies depending on:
a- rapidity of bone formation
b- bone degradation
c- bone remodeling
d- bone modelling
e- vascularity
18- Bone sclerosis means:

a- hyperminerlization and increase bone maturity
b- hypomineralization and bone death
c- hypermineralization and bone death
d- more osteon bone can be seen
19- The distance from the alveolar bone crest to the cemento- enamel junction is:
a- 1.5- 2mm
b- 3- 4mm
c- 0.5- 2mm
d- 1- 3mm
20- The increased radiopacity of the lamina dura is due to:

a- increased mineral content
b- thick bone without trabeculation
c- attachment of the sharpy’s fiber
d- bone seclerosis
21- Functional plasticity of the alveolar bone is due to:

a- lining the alveolus contain all forms of bone histology
b- type I collagen can act as a caution
c- orientation of the osteon is parallel to the stress direction
d- periodntium that can absorb any direction of the force applied
22- The true periodontal ligament (PDL) blood supply is:

a- more abundant in the posterior teeth than anterior
b- greater number in the mandibular than maxillary teeth
c- many arteriovenous anastomosis
d- venous drain is through network in the apical portion
e- all of above
Histology 35
23- At the vermilion border, there is obvious contrast between the colors of the skin and
mucosa, and deeply colored mucosa represents the effects of:
a- amount of the blood vessels
b- epithelium thickness
c- degree of keratinization
d- melanin pigment concentration
e- all of above
24- Epithelial turnover is 52 to 75 days in the skin and 4 to 14 days in the gut, while
gingiva need:
a- 21- 33days
b- 72- 90 days
c- 41- 57 days
d- 120- 142 days
25- The values for insertion torque in different parts of the jawbone were higher in:
a- the mandible than maxilla
b- the anterior than posterior region
c- The maxilla than mandible
d- Posterior than anterior
e- A & b
26- Hemidesmosome- like contacts are observed in the following surfaces:

a- appetite
b- metallic
c- carbon
d- polystyrene
e- a&d
27- Increased bone modelling activity during the first 8 to 10 weeks of socket healing
after extraction leads to the progressive deposition of:
a- woven bone
b- provisional matrix
c- lamellar bone
d- osteon
e- b&c
28- The events involved in osseous wound healing after implant placement:
a- bleeding, hemostasis, clot formation, fibrinolysis, angiogenesis, formation of a loose
connective tissue, osteoblast recruitment, osteoblasts proliferation & differentiation,
collagen matrix formation, mineralization.
b- bleeding, hemostasis, clot formation, fibrinolysis, formation of a loose connective
tissue, angiogenesis, osteoblast recruitment, osteoblasts proliferation &
differentiation, collagen matrix formation, mineralization.
c- bleeding, hemostasis, clot formation, fibrinolysis, formation of a loose connective

tissue, angiogenesis, osteoblast recruitment, collagen matrix formation, osteoblasts
proliferation & differentiation, mineralization.
d- bleeding, hemostasis, clot formation, fibrinolysis, formation of a loose connective
tissue, angiogenesis, osteoblasts proliferation & differentiation, osteoblast
recruitment, collagen matrix formation, mineralization.
29- The important features of the osteoblast include:

a- arise from osteoprogenitor cells of mesenchymal origin
b- osteoblasts are secretory cells
c- osteoblasts are autocrine regulatory cells
d- all of the above
30- Peri- implant tissue may have an impaired defense system due to:
a- devoid of vascular supply
b- lack of keratinized tissue
c- lack of hemidesmosomes attachment
d- lack of perpendicular periodontium
e- b&c
31- Mucosal tissue healing and connective tissue attachment failed when the abutment is
made from:
a- ceramic
b- titanium
c- gold
32- To prevent vertical bone loss and interimplant papillae between 2 adjacent implants,
the minimum distance between two adjacent dental implants should be:
a- 2 mm
b- 3 mm
c- 4 mm
d- 4.5mm
33- Most of the gingiva recession around dental implants occurs during the first
postoperatively:
a- 3 months
b- 1 months
c- 4 months
d- 6 months
e- 6 weeks
Histology 37
34- The platform- switching concept utilizes a smaller diameter abutment platform to:
a- allow submerged the implant
b- allow the formation of the biological space on the remaining platform of the implant
c- allow hemidesomosomes formation
d- get longer junctional epithelium
e- a&c
35- Burnt bone syndrome refers to:

a- Bone resorption has occurred because of damage to the bone at implant placement.
This is caused by failure to cool the bone during the drilling operation.
b- Bone resorption has occurred because of damage to the bone at implant placement.
This is caused by over torque of the implant and pressure necrosis
c- Bone resorption has occurred because of damage to the bone at implant placement.
This is caused by shredding of the bone during implant placement
d- Progressive crestal bone resorption after implant placement. This is caused by failure
to cool the bone during the drilling operation
36- The minimum gap between the implant and host bone predicts a reduction in the
quality and quantity of the newly formed bone when the gap:
a- 300 µm
b- 100 µm
c- 500µm
d- 200 µm
37- The bone implant socket is surgically created compared to a bone wound, with
heating injuries, including the death of osteocytes, extending into the host bone to:
a- 100- 200µm
b- 100- 500 µm
c- 600- 800µm
d- 1- 1.5 mm
38- 3- months post- implantation, the type of bone that can be found on the surface of a
Ti implant is
a- mature woven bone
b- immature woven bone
c- complete lamellar bone
d- mixture (woven and lamellar bone)
39- There is a greater discrepancy in color between the soft tissue of natural teeth and the
soft tissue around the titanium implant when:
a- interdental papillae
b- attached gingiva
c- apical region
40- Crestal bone loss decreases and the epithelial and connective tissue increase when the
implant:
a- placed above the crestal bone
b- placed with the crestal bone
c- placed below the crestl bone (countersink)
d- with micro threads design
41- A patient with square- shaped teeth has better prognosis in the esthetic zone due to:
a- interdental papillae short and blunt
b- long proximal tooth contact
c- thin gingival tissue
d- scalloped gingival margin
e- a & b
42- A patient with conical- shaped teeth is more favorable for immediate implantation in
the esthetic zone due to:
a- ample interdental bone availability
b- thin gingival biotype
c- short contact area
d- all of the above
43- In bone healing, woven bone is formed at a rate of:

a- 120 µm
b- 60µm
c- 200 µm
d- 250 µm
44- Pressure necrosis during implant placement will lead to:

a- micro bone crack
b- soft tissue formation around the implant
c- delay healing
d- bone blood vessels obliteration
e- all of the above
45- Pressure necrosis usually occurs when the implant is placed:

a- in soft bone
b- in narrow bone ridge
c- in dense hard bone
d- with angulation
Histology 39
46- The main difference between the biological width of a natural tooth and an implant
is:
a- shorter junctional epithelium
b- thinner connective tissue
c- longer junctional epithelium
d- thicker connective tissue
e- a & b
47- Generally, the probing depth in healthy implants is greater than that in healthy natural
teeth because:
a- weak attachment of the junctional epithelium
b- implant is deeper than the tooth
c- crestal bone resorption
d- all of the above
48- Inflammation and bleeding on probing around an implant are usually less than with
natural teeth because:
a- less plaque accumulation
b- less blood vessels
c- dense connective tissue with type III collagen
d- sulucus lining by keratinized mucosa
49- Functionally, the oral mucosa and the underlying muscle work as one unit through:
a- interlacing of the lamina propria and muscle
b- firm attachment of the mucosa to the periosteum
c- firm attachment of the mucosa to the perimysium by collagenous
d- raphie formation between the mucosa and the muscle
50- When the distance from the contact point to the bone was 5 mm or less, papillae were
present almost 100% of the time. With a distance of 6 mm, papillae were present 56% of the
time, and when the distance was 7 mm or more, papillae were present:
a- 27%
b- 35%
c- 50%
d-70%
51- The most abundant cells in the connective tissue, which are responsible for the
ground substance formation and play a key role in the healing process and inflammation, are:
a- fibroblast
b- mesenchymal cells
c- macrophage & neutrophil cells
d- endothelial cells
52- In the oral mucosa, unlike in skin, there is minimal scar formation. This attribute may
be correlated with the origin of skin and oral mucosa fibroblasts, as skin fibroblasts originate
from the mesoderm, and mucosal fibroblasts originate from:
a- neural crest
b- endoderm
c- ectoderm
d- a& b
e- b&c
53- Aging in the oral mucosa may involve:

a- epithelium reduced in thickness and mitotic activity
b- collagen fibres thickened and dense
c- fibroblast reduced in number, activity and size
d- increased of cross- linking in elastin, lead to loss of mucosal resiliency
e- all of the above
54- A Submarginal incision is often preferred when crowns and bridges are present to
preserve the blood supply to the labial marginal tissues, which comes from:
a- crestal bone
b- lingual papillae
c- periodontium
d- periosteum
e- a & b
55- Postnatal stem cells in the bone marrow with a distinct population can be found:
a- hematopoietic stem cells
b- mesenchymal stem cells
c- endodermal stem cells
d- ectodermal stem cells
e- a & b
56- The linear apposition rate for human lamellar bone is:
a- 1.5 µm/day
b- 2- 3µm/day
c- 5- 7µm/day
d- 10- 12µm/day
57- Lamellar bone cannot form a scaffold, such as woven bone, but rather grows by
apposition on a preformed solid base, such as:
a- woven bone
b- pre- existing or pristine bone
c- implant surface
d- all of the above
Histology 41
58- After the healing period, the implant surface adjacent to cancellous bone is covered
almost completely by:
a- 100- 200µm layer of woven bone
b- 100- 200µm layer of lamellar bone
c- 300- 400µm layer of lamellar bone
d- 200- 300µm mixture layer of lamellar bone and woven bone
59- Cancellous bone contributes much less to the implant primary stability than does
cortical bone because of the volume density of the bone matrix in cortical bone, which is
approximately 80- 90%, while in cancellous bone it is only:
a- 30- 40%
b- 10- 20%
c- 20- 25%
d- 5- 10%
60- Large, multinuclear, osteoclast cells originate from:

a- monocytes
b- preosteoblast
c- macrophage
d- mature osteocytes
61- The shape of an interdental papilla is determined by:

a- The embrasure contour
b- collagen composition
c- the anatomy of its adjacent teeth
d- the distance from the contact area to the crestal bone
e- a&c
62- Keratinized tissue will be minimal in the area of:

a- maxillary first premolar tooth
b- mandibular first premolar tooth
c- mandibular first molar tooth
d- mandibular incisor teeth
e- maxillary first molar tooth
63- From a histological point of view, the keratinized tissue around dental implants is
preferred over non- keratinized tissue because keratinized tissue can provide:
a- more blood supply
b- short junctional epithelium
d- more hemidesmosomes attachment
64- The inner layer of the periosteum, known as the cambial region, contains:
a- connective tissue
b- fibroblast cells
c- undifferentiated mesenchymal cells
d- nerve tissue
e- a&b
65- The orientation of collagen fibers in keratinized gingiva around the implant is:
a- parallel to the implant surface and inserted into the implant surface
b- perpendicular to the implant surface but not inserted into the implant surface
c- perpendicular to the implant surface but not inserted into the implant surface
d- angled to the implant surface and inserted into the implant surface
e- perpendicular to the implant surface and inserted into the implant surface
66- An implant placed immediately into a fresh extraction socket has different biological
widths, ending with:
a- apical migration of the junctional epithelium
b- increase the width of the connective tissue
c- decrease the width of the connective tissue
d- decrease sulcus depth
e- c&d
67- In a single- stage implant procedure and after the abutment placement heals, the peri-
implant soft tissue maturation and junctional epithelium apical migration will be completed
in:
a- 2weeks
b- 12- 24 weeks
c- 4 weeks
d- 6- 8weeks
68- from a histological point of view, thick, gingival soft tissue is characterized by:
a- high volume of extracellular matrix and collagen
b- decrease vascularity that compromise wound healing
c- increased vascularity, which enhance immune response
d- connective tissue has less potential of keratinized tissue formation
e- a&c
69- in natural teeth, the depth of the gingival sulci varies enormously depending on:
a- site of the tooth
b- presence or absence of adjacent teeth
c- diastemae
d- thickness of the connective tissue in biological width
e- passive eruption
Histology 43
CORRECT ANSWERS
Q1
a- collagen fibers non- attached to the dental implant and run parallel to the implant
surface
Q2
c- junctional epithelium attachment 0.97mm, connective tissue attachment of 1.07mm or
in sum approximately 2mm
Q3
b- thin plate more subjected to be fracture during extraction
Q4
a- hemidesmosomes
Q5
d- all of above
Q6
c- type IV collagen
Q7
b- fibroblast cells
Q8
e- all of above
Q9
a- tensile and slicing stresses
Q10
c- I collagen
Q11
d- all of above
Q12
a- bone cells, precursors cells, blood vessels
Q13
c- collagenous and noncollagenous bone matrix protein
Q14
a- mainly collagen that act as a scaffold
Q15
d- a&b
Q16
e- all of the above
Q17
a- rapidity of bone formation
Q18
c- hypermineralization and bone death
Q19
a- 1.5- 2mm
Q20
b- thick bone without trabeculation
Q21
a- lining the alveolus contain all forms of bone histology
Q22
e- all of above
Q23
e- all of above
Q24
c- 41- 57 days
Q25
e- A & b
Q26
e- a, d
Q27
a- woven bone
Q28
b- bleeding, hemostasis, clot formation, fibrinolysis, formation of a loose connective
tissue, angiogenesis, osteoblast recruitment, osteoblasts proliferation & differentiation,
collagen matrix formation, mineralization
Q29
d- all of the above
Histology 45
Q30
a- devoid of vascular supply
Q31
c- gold (gold surface chemically not stable )
Q32
b- 3 mm
Q33
a- 3 months
Q34
b- allow the formation of the biological space on the remaining platform of the implant
Q35
a- bone resorption has occurred because of damage to the bone at implant placement.
This is caused by failure to cool the bone during the drilling operation.
Q36
c- 500µm
Q37
b- 100- 500 µm
Q38
d- mixture (woven and lamellar bone)
Q39
none of the above (gingival margin)
Q40-
c- placed below the crestl bone (countersink)
Q41
e- a & b
Q42
a- ample interdental bone availability
Q43
b- 60µm
Q44
e- all of the above
Q45
e- in dense hard bone
Q46
c- longer junctional epithelium
Q47
a- weak attachment of the junctional epithelium
Q48
b- less blood vessels
Q49
c- firm attachment of the mucosa to the perimysium by collagenous
Q50
27% of the time or less
Q51
a- fibroblast
Q52
a- neural crest
Q53
e- all of the above
Q54
e- a & b
Q55
e- a & b
Q56
a- 1- 1.5 µm/day
Q57
d- all of the above
Q58
b- 100- 200µm layer of lamellar bone
Q59
c- 20- 25%
Histology 47
Q60
a- monocytes
Q61
e- a&c
Q62
b- mandibular first premolar
Q63
d- more hemidesmosomes attachment
Q64
c- undifferentiated mesenchymal cells
Q65
c- perpendicular to the implant surface but not inserted into the implant surface
Q66
a- apical migration of the junctional epithelium
Q67
d- 6- 8weeks
Q68
e- a&c
Q69
d- thickness of the connective tissue in biological width
REFERENCES
Abrahamsson I, berglundh T, Glantz PO, lindhe j. The mucosal attachment at different
abutments. An experimental study in dogs. J Clin Periodontol 1998;25:721–7.
Al- Sabbagh M Implant in the esthetic zone. Den Clin N Am 2006;50:391–407.
Araujo MG, Sukekava F, Wennstrom, JL, Lindhe, J. Ridge alterations following implant
placement in fresh extraction sockets: an experimental study in the dog. J Clinical
Periodontol 2005;32:645–652.
Araujo MG, Sukekava F., Wennstrom JL, Lindhe J. Tissue modeling following implant
placement in fresh extraction sockets. Clin Oral Implants Res 2006;17:615–624.
Baumgarten H. A new implant design for crestal bone preservation: Initial observations and
case report. Pract Proced Aesthet Dent 2005:17:735–740.
Berglundh T, Abrahamsson I, Welander M, Lang NP, Lindhe, J. Morphogenesis of the peri-
implant mucosa: an experimental study in dogs. Clin Oral Implants Res 2007;18:1–8.
Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. he soft tissue

barrier at implants and teeth. Clin Oral Implants Res 1991;2:81–90.
Berglundh T, Lindhe J, Jonsson K, Ericsson I. The topography of the vascular systems in the
periodontal and peri-implant tissues in the dog. J Clin Periodontol. 1994;21:189–93.
Berglundh T., Lindhe J., Jonsson K, Ericsson I., The topography of the vascular systems in
the periodontal and peri-implant tissues in the dog. J Clin Periodontol. 1994;21:189–93.
Chappard D, Aguado E, Huré G, Grizon F, Basle MF The early remodeling phases around
titanium implants: a histomorphometric assessment of bone quality in a 3- and 6-month
study in sheep. Int J Oral Maxillofac Implants 1999;14:189–96.
Chappuis V, Engel O, Shahim K, Reyes M, Katsaros C, Buser D Soft Tissue Alterations in
Esthetic Postextraction Sites: A 3-Dimensional Analysis. J Dent Res. 2015;94(9
Suppl):187S–93S.
Cooper LF Biologic determinants of bone formation for osseointegration: Clues for future
clinical improvements. J Prosthet Dent 1998;80: 439–449.
Elian N, Bloom M, Trushkowsky RD, Dard MM, Tarnow D. Effect of 3- and 4-mm
interimplant distances on the height of interimplant bone crest: a histomorphometric
evaluation measured on bone level dental implants in minipig. Implant Dent
2014;23:522–8.
Farré-Pagés, N., Augé-Castro, M.L., Alaejos-Algarra, F., Mareque-Bueno, J., Ferrés-Padró,
E. & Hernández-Alfaro, F. Relation between bone density and primary implant stability.
Med Oral Patol Oral Cir Bucal. 2011;16: e62–e67.
Ferguson DB Oral Bioscience, Chrchill Livingstone, 1999.
Floyd P, Palmer P, Palmer R Radiographic techniques. Br Dent J 1999;187:359–65.
Futami T, Fujii N, Ohnishi H, Taguchi N, Kusakari H, Ohshima H, Maeda T Tissue response
to titanium implants in the rat maxilla: ultrastructural and histochemical observations of
the bone-titanium interface. J Periodontol 2000;71:287–98.
Garn SM, Van Alstine WL Jr, Cole PE Relationship between root lengths and crown
diameters of corresponding teeth. J Dent Res. 1978;57:636.
Giavaresi G, Fini M, Cigada A, Chiesa R, Rondelli G, Rimondini L, Aldini NN, Martini L,
Giardino R Histomorphometric and microhardness assessments of sheep cortical bone
surrounding titanium implants with different surface treatments. J Biomed Mater Res A
2003;67:112–20.
Huynh-Ba G, Pjetursson BE, Sanz M, Cecchinato D, Ferrus J, Lindhe J, Lang NP. Analysis
of the socket bone wall dimensions in the upper maxilla in relation to immediate implant
placement. Clin. Oral Impl. Res. 21, 2010; 37–42.
Jansen JA, de Wijn JR, Wolters-Lutgerhorst JM, van Mullem PJ Ultrastructural study of
epithelial cell attachment to implant materials. J Dent Res. 1985;64:891–6.
Listgarten MA Soft and hard tissue response to endosseous dental implants. Anat Rec
1996;245:410–25.
Maria OM, Khosravi R, Mezey E, Tran SD. Cells from bone marrow that evolve into oral
tissues and their clinical applications. Oral Dis 2007;13:11–6.
Misch CE. Contemporary Implant Dentistry. St Louis, Mo: Mosby-Year Book; 2008, 3rd
edition.
Miyamoto I, Tsuboi Y, Wada E, Suwa H, Iizuka T. Influence of cortical bone thickness and
implant length on implant stability at the time of surgery-clinical, prospective,
biomechanical, and imaging study. Bone 2005;37:776–780.
Histology 49
Park SE, Da Silva JD, Weber HP, Ishikawa-Nagai N Optical phenomenon of peri-implant soft
tissue. Part I. Spectrophotometric assessment of natural tooth gingiva and peri-implant
mucosa. Clin Oral Impl Res 2007;18:569–574.
Saadoun, A. P. & Touati, B. Soft tissue recession around implants: is it still unavoidable? Part
I. Pract Proced Aesthet Dent 2007;19:55–62.
Sandborn PM, Cook SD, Spires WP, Kester MA. Tissue response to porous-coated implants
lacking initial bone apposition. J Arthroplasty 1988;3:337–46.
Schenk RK, Buser D Osseointegration: a reality. Periodontology 2000 1998;17:22–35.
Schroeder HE, Listgarten MA. The gingival tissues: the architecture of periodontal protection.
Periodontol 2000 1997;13:91–120.
Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone healing and soft tissue contour
changes following single-tooth extraction: A clinical and radiographic 12-month
prospective study. Int J Periodontics Restorative Dent 2003;23:313–323.
Small PN, Tarnow DP Gingival recession around implants: a 1-year longitudinal prospective
study. Int J Oral Maxillofac Implants. 2000;15:527–32.
Soadoun, A. P. & Touati, B. Soft tissue recession around implants: is it still unavoidable? Part
II. Pract Proced Aesthet Dent 2007;19:81–7.
Tarnow D, Magner APF. The effect of the distance from the contact point to the crest of bone
on the presence or absence of the interproximal dental papilla. J Periodontol 1992;63:
995–996.
Tarnow DP, Cho SC, Wallace SS The effect of inter-implant distance on the height of inter-
implant bone crest. J Periodontol. 2000;71:546–9.
Todescan FF, Pustiglioni FE, Imbronito AV, Albrektsson T, Gioso M Influence of the
microgap in the peri- implant hard and soft tissues: a histomorphometric study in dogs.
Int J Oral Maxillofac Implants 2002;17:467–72.
Trombelli, L., Farina, R., Marzola, A., Bozzi, L., Liljenberg, B. Lindhe, J. Modeling and
remodeling of human extraction sockets. J Clin Periodontol 2008;35: 630–639.
Velvart P Papilla base incision: a new approach to recession-free healing of the interdental
papilla after endodontic surgery. Int Endod J 2002;35:453–60.
Wagenberg B, Ginsburg T. Immediate Implant Placement on Removal of the Natural Tooth:
Retrospective Analysis of 1,081 Implants. Compendium 2001; 22(5): 399–40.
Weiss CM Acompartive analysis of fibro-osteal and osteal integration and other variable that
affect long term bone maiontenance around dental implant. J Oral Implantol
1987;13:467–87
Weiss CM Tissue integration of dental endosseous implants: description and comparative
analysis of the fibro-osseous integration and osseous integration systems. J Oral
Implantol 1986;12:169–214.
Winet H The role of microvasculature in normal and perturbed bone healing as revealed by
intravital microscopy. Bone 1996;19(1 Suppl):39S–57S.
Chapter 4
PHARMACOLOGY
1- Some antibiotics are bacteriostatic in nature but bactericidal in high doses, such as:
a- erythromycin
b- amoxycillin
c- tetracycline
d- metronidazole
e- cephalosporin
2- Metronidazole is contraindicated in patients who:

a- epileptic
b- diabetic
c- asthmatic
d- alcoholic
e- psoriatic
3- Tegretol is used for the treatment of epilepsy and prescribed for patients suffering from
trigeminal neuralgia. Patient taking this drug should have regular blood tests to check for:
a- increase of platelet
b- decrease of neutrophil
c- decrease of erythrocyte
d- decrease of T- cells
e- decrease of platelet
4- Patients allergic to penicillin have a 10% chance of cross allergies with:

a- amoxycillin
b- tetracyclin
c- cephalosporin
d- erythromycin
e- quinolone
5- The local anesthesia of choice to treat pain for a longer period postoperatively is:
a- bupivacaine
b- mepivacaine
c- prilocain
d- articaine
e- trimicaine
6- A combination of antibiotics is crucial in the treatment of peri- implantitis, and the

most commonly used drugs include:
a- metronidazole and amoxicillin
b- metronidazole and clindamycin
c- metronidazole and erythromycin
d- metronidazole and cephalosporins
7- The anti- anginal drug nitroglycerin has an onset of action within:

a- 5- 10 minutes
b- 10- 15 minutes
c- 20- 30 minutes
d- 1- 3 minutes
8- Beta adrenergic blocking agents have drug interactions with:

a- epinephrine
b- lidocaine
c- NSAIDs
d- all of the above
9- For better control of peri- and postoperative bleeding in patients with severe
hemophilia:
a- postoperatively tranexamic acid+ preoperative start coagulation factor+ antibiotic (
augmentin)
b- preoperative start and continue postoperatively tranexamic acid+ preoperative start
coagulation factor+ combined antibiotic (metronidazole + augmentin)
c- preoperative start and continue postoperatively tranexamic acid+ preoperative start
coagulation factor
d- preoperative start coagulation factor+ combined antibiotic (metronidazole +
augmentin)
10- Erythromycin should not prescribed when the patient is taking:

a- theophylline
b- terfenadine
c- carbamazepine
d- triazolam
e- all of the above
Pharmacology 53
11- Ibuprofen should not prescribed when the patient is taking:

a- oral anticoagulant
b- lithium
c- astemizole
d- amoxicycilline
e- a&b
12- Naproxen should not prescribed when the patient is taking:

a- tetracycline
b- Ca channel blocker
c- Benzodiazepines
d- antihistamine
13- Epinephrine should not prescribed when the patient is taking:

a- tricyclic antidepressants
b- monoamine oxidase inhibitors
c- anticoagulant
d- angiotensin inhibitor
e- a&b
14- The following drugs should be not be prescribed for patients who consume alcohol:
a- metranidazole
b- benzodiazepines
c- opiod analgesics
d- all of the above
15- When the patient is prescribed tetracycline, he or she should avoid food products that
cause drug- food interactions, such as:
a- milk and milk product
b- iron
c- high protein food
d- fruit
e- a&b
16- When the patient is prescribed erythromycin, he or she should avoid food products
that cause drug- food interaction, such as:
a- fruit and fruit juices
b- tomatoes
c- pyridoxin
d- antacids
e- a&b
17- When the patient is prescribed digoxin, he or she should avoid food products that
a- chocolate
b- spinach
c- cereal grains
d- nuts
e- all of the above
18- When the patient is prescribed calcium channel blockers, he or she should avoid food
products that cause drug- food interactions, such as:
a- grape fruit
b- milk
c- beans
d- coffee
e- all of the above
19- When the patient is prescribed quinolones, he or she should avoid food products that
a- nuts
b- caffeine
c- antacids
d- egg
e- all of the above
20- Many pharmaceutical drugs can alter the sense of taste, including:
a- Antidepressants
b- diuretics
c- muscle relaxant
d- antidiabetics
e- all of the above
21- Many pharmaceutical drugs can cause dry mouth, including:

a- carbamazepine (anticonvulsant)
b- loratidine (antihistamine)
c- captopril (antihypertensive)
d- ibuprofen (NSAIDs)
e- all of the above
22- When a patient is taking zidovudine (AZT), the following antibiotic should not
prescribed because it causes a drug interaction:
a- clarithromycin
b- trimethoprim
c- tetracycline
d- penicillin G
e- a&b
Pharmacology 55
23- Verapamil is a calcium channel blocker drug with oral side effects:
a- dry mouth
b- gingival hyperplasia
c- oral ecchymosis
d- mouth ulcers
e- a&b
24- Tramadol hydrochloride is a centrally acting analgesia. All of the following are true
about this drug except:
a- cause vertigo
b- cause drug interaction with codeine
c- the dosage should not exceed 400mg/day
d- cause drug dependence
e- cause stomatitis
25- Tiludronate disodium is used to treat Paget’s disease. All of the following are true
about this drug except:
a- inhibit the activity of osteoclast
b- cause dry mouth
c- interfere with bone mineralization
d- hypertension
e- interact with aspirin and indomethacin
26- Tetracycline has many side effects, including all of the following except:
a- increase yellow- brown discoloration of the teeth
b- cause softening of teeth and bone
c- interact with antacids
d- cause canker ulcer
e- cause photosensitivity
27- Quinidine sulfate is an antiarrhythmic drug, and patient on chronic drug therapy may
suffer from:
a- orthostatic hypotension
b- blood dyscrasias
c- bleeding
d- poor wound healing
e- all of the above
28- Phenytoin is an anticonvulsant and antiarrhythmic drug that has drug interactions
with:
a- benzodiazepines
b- doxycycline
c- metrnidazole
d- corticosteriod
e- all of the above
29- Phenytoin is an anticonvulsant and antiarrhythmic drug with oral side effects:
a- gingival hyperplasia
b- loss of test
c- stomatities
d- tongue enlargement
e- a&b
30- Omeprazole suppresses gastric acid secretion. All of the following are true about this
drug except:
a- cause mucosal atrophy of the tongue
b- cause gingival hyperplasia
c- inter act with diazepam
d- when used with clarithromycin will cause tongue discoloration
e- cause candidiasis
31- Minoxidil is an antihypertensive drug that will cause:

a- blood dyscrasias
b- drug interaction with NSAIDS
c- stomatitis
d- orthostatic hypotension
e- a&b
32- Metronidazole is an antibiotic with the following adverse effect:

a- dry mouth
b- metallic test
c- furry tongue
d- stomatitis (due to overgrowth of candida)
e- all of the above
33- Methyldopa is an antihypertensive drug. All of the following are true about this drug
except:
a- contraindicated in impaired renal function
b- cause drug interaction with NSAIDs
c- cause lichenoid drug reaction
d- cause “black tongue”
e- cause sialoadenitis
34- Epinephrine is an adrenergic drug and sympathomimetic drug. All of the following
are true about this drug except:
a- in the area of the nose, ear and fingers should be administrated with small quantities
b- cross the placenta and blood brain barrier
c- use in the treatment anaphylactic shock and drug induce allergic reaction
d- stimulate alpha, beta- 1 and beta- 2 receptors
e- prolong the action of local anaesthetic
Pharmacology 57
35- Doxycycline is in the tetracycline group of drugs. All of the following are true about
this drug except:
a- slowly absorbed
b- contraindicated in pregnant and in children less than 6 years old
c- cause drug interaction with the anticoagulants
d- use for the treatment of syphilis and gonorrhea
e- used for the treatment of necrotizing ulcerative gingivostomatitis
36- Diabetic patients being treated with insulin can have drug interactions with:
a- epinephrine (↓effect of insulin)
b- corticosteriod (↓effect of insulin)
c- NSAIDs
d- anticoagulant
e- a&b
37- Cephalosporin has drug interactions with:

a- antidepressant tricyclic
b- antacids
c- bacteriostatic agents (tetracycline, erythromycin)
d- diazepam
e- a&b
38- Aspirin is an anti- inflammatory drug that can cause all of the following except:
a- anti- diabetic
b- peptic ulcer (stomach and duodenum ulcer)
c- increase thyroid hormone level
d- ↓the effect of coumarin- type drugs
e- Reye’s syndrome (fatty degeneration in liver and kidney)
39- When antibiotics are used in combination, they may enhance or synergize one
another. This can occur when we combine:
a- bactericidal and bactericidal
b- bactericidal and bacteriostatic
c- broad spectrum and narrow spectrum antibiotic
d- broad spectrum and broad spectrum antibiotic
e- narrow spectrum and narrow spectrum antibiotic
40- Benzodiazepine can be used for all of the following except:

a- anti anxiety
b- sedative and hypnotic
c- analgesia
d- anticonvulsant
e- muscle relaxant
41- Antihistamine drugs, such as terfenadine and astemizole, may cause cardiac
arrhythmia if they interact with:
a- erythromycin
b- imidazole
c- tegretol
d- tricyclic antidepressant
e- a&b
42- The truth about chlorhexidine is:

a- causes changes in bacterial cell wall permeability
b- mainly effective against Gram- positive bacteria
c- adheres to tooth enamel, pellicle and plaque
d- can decrease the bacterial account to 10%
e- all of the above
43- The maximum safe dosage for 2% lignocaine with adrenaline for adult patients is:
a- 18 ml- 8 cartridges of 2.2ml
b- 12.5 ml- 5- 6 cartridges of 2.2ml
c- 9.5 ml- 4 cartridges of 2.2 ml
d- 22 ml- 10 cartridges of 2.2ml
44- Bisphosphonates inhibit bone resorption or destruction by:

a- enhance collagen cross reacting
b- activate bone formation through the activation of osteopontien protein
c- increase bone density by increasing the secretion of the osteopontien protein
d- inhibiting recruitment and promoting apoptosis of osteoclasts
e- all of the above
45- Bisphosphonates are used to treat:

a- paget’s disease
b- osteoporosis
c- fibrous dysplasia
d- multiple myeloma
e- all of the above
46- For minor peripheral nerve trauma or pressure that may be associated with early
paresthesia, the pharmacological therapy is:
a- dexamethason 2mg postoperative for one week
b- ibuprofen (600mg to 800 mg) +Vitamins B complex
c- decadron 4mg IV for 3 days
d- tegretol (200 mg) +Vitamins B complex
Pharmacology 59
47- For intraoperative visible nerve compression or trauma, the best pharmaceutical
remedy is:
a- application of 4ml IV form of decadron directly on the nerve + oral dexamethasone
postoperatively for 6 days (4mg for first 3 days, 2mg for 3 days)
b- tegretol (200 mg) +Vitamins B complex +Ibuprofen 800 mg
c- 4ml of decadron given IM or IV during surgery + oral dexamethasone post-
operatively for 6 days (4mg)
d- 4ml of decadron given IV or IM during surgery + 4ml IV or IM of decadron post-
operatively for 3 days
e- 4ml of decadron given IM or IV during surgery + Vitamins B complex +Ibuprofen 800
mg
48- Bone morphogenetic protein (BMP) is contraindicated for which of the following
patients:
a- active malignancy
b- pregnant women
c- active infection at the surgical site
d- skeletally immature
e- all of the above
49- The following are all common side effects of bone morphogenetic protein (BMP)
except:
a- facial edema
b- delay soft tissue healing
c- oral erythema
d- pain
e- rhinitis (when applied in maxillary sinus)
CORRECT ANSWERS
Q1
a- erythromycin
Q2
d- alcoholic
Q3
b- decrease of neutrophil
Q4
c- cephalosporin
Q5
a- bupivacaine
Q6
a- metronidazole and amoxicillin
Q7
d- 1- 3 minutes
Q8
d- all of the above
Q9
b- preoperative start and continue postoperatively tranexamic acid+ preoperative start
coagulation factor+ combined antibiotic (metronidazole + augmentin)
Q10
e- all of the above
Q11
e- a&b
Q12
Q13
e- a&b
Q14
d- all of the above
Q15
e- a&b
Q16
e- a&b
Q17
e- all of the above
Q18
a- grape fruit
Q19
c- antacids
Q20
e- all of the above
Pharmacology 61
Q21
e- all of the above
Q22
e- a&b
Q23
e- a&b
Q24
b- cause drug interaction with codeine
Q25
c- interfere with bone mineralization
Q26
d- cause canker ulcer
Q27
e- all of the above
Q28
e- all of the above
Q29
e- a&b
Q30
b- cause gingival hyperplasia
Q31
e- a&b
Q32
e- all of the above
Q33
a- contraindicated in impaired renal function
Q34
b- cross the placenta and blood brain barrier (cross only placenta)
Q35
b- contraindicated in pregnant and in children less than 6 years old (less than 8 years old)
Q36
e- a&b
Q37
c- bacteriostatic agents (tetracycline, erythromycin) (↓effect of cephalosporin)
Q38
d- ↓the effect of coumarin- type drugs
Q39
a- bactericidal and bactericidal
Q40
c- analgesia
Q41
e- a&b
Q42
e- all of the above
Q43
a- 18 ml- 8 cartridges of 2.2ml
Q44
d- inhibiting recruitment and promoting apoptosis of osteoclasts
Q45
d- all of the above
Q46
b- ibuprofen (600mg to 800 mg) +Vitamins B complex
Q47
a- application of 4ml IV form of decadron directly on the nerve + oral dexamethasone
postoperatively for 6 days (4mg for first 3 days, 2mg for 3 days)
Q48
e- all of the above
Q49
b- delay soft tissue healing
Pharmacology 63
REFERENCES
Astasov-Frauenhoffer M, Braissant O, Hauser- Gerspach I, Weiger R, Walter C, Zitzmann
NU, Waltimo T. Microcalorimetric Determination of the Effects of Amoxicillin,
Metronidazole, and Their Combination on In Vitro Biofilm Periodontol 2014;85:349–
357.
Castellanos-Cosano L1, Núñez-Vázquez RJ, Segura-Egea JJ, Torres-Lagares D, Corcuera-
Flores JR, Machuca-Portillo G. Protocol for oral implant rehabilitation in a hemophilic
HIV-positive patient with type C hepatitis m Implant Dent. 2014;23:622–5.
Chestnut IG, Gibson j, Churchill’s Pocketbook of Clinical Dentistry, Churchill Livingstone,
London, 1998.
Haveles EB, Delmar’s Dental Drug Reference, Thomson, New York, 2000.
Weinstein RS, Roberson PK, Manolagas SC Giant osteoclast formation and long-term oral
bisphosphonate therapy. N Engl J Med 2009;360:53–62.
Chapter 5
BIOLOGY
1- PRP offers many advantages:

a- decreases the frequency of intraoperative and postoperative bleeding at the recipient
sites
b- aids in the initial stability of the grafted tissue at the recipient sites as a result of its
cohesive and adhesive nature
c- may promote rapid vascularization of the healing tissue by delivering growth factors
d- it induces soft- and hard- tissue regeneration.
e - all of above
2- Completely intact bony walls sockets will regenerate bone with almost any resorbable
graft material. In cases of labial plate thickness, the material should be:
a- 1.5mm and above
b - 1mm and above
c- 2mm and above
d- 0.5 and above
e- minimum 2.5mm
3- Bone resorption is not a direct process, which means:

a- bone matrix attack before hydroxyapatite crystal
b- osteoclast get signals from the macrophage
c- osteoclast activated from the osteoblast
d- always there is external stimulation to start the resorption process
e- all of the above
4- A patient experiencing pain from the dental implant during mastication indicates that:
a- implant failure
b- implant placed adjacent to the nerve tissue
c- crestal bone loss
d- peri- implantities
e- a&c
5- For optimum healing during flap closure, the following tissues should be sutured:
a- periosteal tissue
b- epithelial tissue
c- connective fibrous tissue
e- all of the above
6- Bone heating up to ____________________ for 1 minute is sufficient to impair bone

formation:
a- 32˚C
b- 37˚C
c- 44˚C
d- 47˚C
7- More than 4 abutment dis/reconnections will lead to:

a- increase vertical periimplant bone resorption
b- microgap between the implant and the abutment
c- wear of abutment screw
d- increase stress around the implant
e- a&c
8- In a patient suffering from squamous carcinoma in the lateral surface of the tongue
who needs an implant in a partially edentulous area of the left maxilla, the optimal time to
place the implant is:
a- before radiotherapy
b- after radiotherapy ended
c- simultaneously during ablative tumour surgery
d- a & c
9- Radiation dosage during radiotherapy of head and neck cancers is crucial when the
patient will be undergoing dental implant treatment. There will be impaired bone healing and
implant osseointegration when the dosage exceeds:
a- 40 Gy
b- 50 Gy
c- 30 Gy
d- 20 Gy
e- c&d
Biology 67
10- To decrease the rate of implant failure, the required time interval between
radiotherapy and implant placement should be longer than:
a- 4 months
b- 6 months
c- 24 months
d- 3 months
11- Bone remodeling characterizes the last stage of osseointegration but continues for the
rest of the life of the implant. This process has sequence stages for completion:
a- vascular loop formation with perivascular osteoprogenitor cells, resorption by
osteoclasts (cutting cone), deposit concentric layers of lamellar bone by osteoblast
b- deposit concentric layers of lamellar bone by osteoblast, vascular loop formation with
perivascular osteoprogenitor cells, resorption by osteoclasts (cutting cone)
c- resorption by osteoclasts (cutting cone), deposit concentric layers of lamellar bone by
osteoblast, vascular loop formation with perivascular osteoprogenitor cells
d- resorption by osteoclasts (cutting cone), vascular loop formation with perivascular
osteoprogenitor cells, deposit concentric layers of lamellar bone by osteoblast
12- Osteogenesis can be defined as:

a- Process by which viable osteoblasts and precursor cells establish regions of bone
formation
b- Material surfaces act as scaffold for vascular ingrowth, cellular attachment, and
osteogenesis
c- Process of transformation of recruited precursor cells into osteoblastic cells
d- Directing bone formation at local osseous sites using membrane barrier techniques
13- Osteoconduction can be defined as:

formation
osteogenesis
14- Osteoinduction can be defined as:

formation
osteogenesis
15- Osteopromotion can be defined as:

a- directing bone formation at local osseous sites using membrane barrier techniques
b- material surfaces act as scaffold for vascular ingrowth, cellular attachment, and
osteogenesis
c- process of transformation of recruited precursor cells into osteoblastic cells
d- process by which viable osteoblasts and precursor cells establish regions of bone
formation
16- Collagen I is one of the matrix proteins of bone with a function of:
a- structural scaffold
b- directs mineralization
c- cell attachment
d- all of above
17- Fibronectin is one of the matrix proteins of bone with a function of:
a- structural scaffold
b- cell attachment and signalling
c- directs mineralization
d- hydroxyapatite binding
18- Osteonectin is one of the matrix proteins of bone with a function of:
a- limits cell spreading
b- binds Ca++ and hydroxyapatite
d- a & b
19- Osteopontin is one of the matrix proteins of bone with a function of:
a- directs mineralization
b- hydroxyapatite binding
c- regulation of cell function
d- biologic control of bone turnover
e- b&c
20- Bone sialoprotein is one of the matrix proteins of bone with a function of:
a- regulation of cell function
b- binds collagen
d- structural scaffold
e- a&b
21- Osteocalcin is one of the matrix proteins of bone with a function of:
a- biologic control of bone turnover
b- unknown
c- structural scaffold
d- cell attachment
e- a&d
Biology 69
22- Platelet- derived growth factor is one growth factor in a bone matrix that comes from
and has functions of:
a- platelets/serum (osteoblast) and act as regulates osteogenesis
b- platelets/serum (osteoblast) and act as mitogenic, angiogenic
c- platelets/serum (osteoblast) and act as mitogenic
d- platelets/serum (osteoblast) and act as osteoinductive
23- Insulin- like growth factor is one growth factor in a bone matrix that comes from and
has functions of:
a- platelets/serum (osteoblast) and act as mitogenic
b- serum, osteoblast or bone matrix and act as mitogenic
c- endothelial cells/bone matrix and act as mitogenic, angiogenic
d- osteoblast or bone matrix and act as Regulates osteogenesis
24- Fibroblastic growth factor is one growth factor in a bone matrix that comes from and
has functions of:
b- endothelial cells/bone matrix and act as mitogenic, angiogenic
c- osteoblast or bone matrix and act as regulates osteogenesis
d- osteoblast or bone matrix and act as osteoinductive
25- Transforming growth factor beta is one growth factor in a bone matrix that comes
from and has functions of:
b- osteoblast or bone matrix and act as osteoinductive
d- osteoblast or bone matrix and act as regulates osteogenesis
26- Bone morphogenetic protein is one growth factor in a bone matrix that comes from
and has functions of:
a- osteoblast or bone matrix and act as osteoinductive, regulates osteogenesis
b- platelets/serum (osteoblast) and act as mitogenic
d- osteoblast or bone matrix and act as regulates osteogenesis
27- Implant surfaces are considered:

a- osteogenic surface
b- alloplastic surface
c- osteoinductive surface
d- osteopromotion surface
28- All wounds heal using a combination of 3 mechanisms:

a- contraction, epithelisation and connective tissue formation
b- vascularisation, epithelisation and connective tissue formation
c- epithelisation, vascularisation and connective tissue formation
d- vascularisation, stromal tissue formation and connective tissue formation
29- All wounds heal in 4 stages, including:

a- haemostasis, inflammation, scaring and remodelling
b- haemostasis, epithelisation, proliferation and remodelling
c- bleeding, haemostasis, epithelisation and remodelling
d- haemostasis, inflammation, proliferation and remodelling
30- Dynamic excessive loads perpendicular to the implant axis have been shown to cause
____________________ bone loss around the marginal part of the implant:
a- horizontal
b- Vertical
c- crater- like
d- all of the above
31- Cytokines are soluble polypeptides that mediate and regulate the immune system and
can also enhance bone resorption:
a- interleukin- 1 (IL- 1)
b- tumour necrosis factor- a (TNFa)
c- Prostaglandin E2 (PGE2)
d- interleukin- 6 (IL- 6)
e- a & b
32- Commercially pure (C.P.) titanium is usually recognized as the gold standard. C.P.
titanium’s unique biocompatibility is attributed to:
a- stable surface
b- passive oxide surface
c- corrosion resistance
d- all of the above
33- Regarding the surface topography of implants, three categories of roughness can be
found:
a-minimally rough Sa 0.5–1mm, moderately rough Sa 1–2mm and rough Sa >2mm
b-minimally rough Sa 0.5–1mm, moderately rough Sa 1–2mm and rough Sa >3mm
c-minimally rough Sa 0.5–1mm, moderately rough Sa 1–3mm and rough Sa >4mm
d- minimally rough Sa 1–2mm, moderately rough Sa 2–2.5mm and rough Sa >3mm
Biology 71
34- Chemically and physically modified implant surfaces have different roughness, but
acid etched, sandblasted and anodized surfaces can be classified under:
a- minimally rough
b- highly rough
c- rough
35- Modified SLA (sandblasted, large grit, acid- etched) implant surface that are
immersed in isotonic solution and N2 protection will produce chemically active and clean
surfaces due to:
a- osteoblast chemotactic
b- reduce hydrocarbon contamination
c- micro rough surface
d- macro rough surface
e- a& c
36- Hydrocarbon deposition on an implant surface will lead to:

a- increrase the thickness of TiO layer on the implant
b- increase of the chemotactic activity
c- attenuates osteoblast activity (ALP activity reduced, calcium mineralization reduced)
d- enhancing the blood clot attachment
e- a&b
37- The early marker protein of osteogenic differentiation, which is also found in high-
level osteoblast cells that mineralize their matrix, is:
a- osteopontin
b- osteonectin
c- alkaline phosphatase
d- calcitonen
38- Hydroxyapatite (HA) activity of the coated implant is considered:

a- osteoconductive
b- osteoinductive
c- osteogenesis
39- Micropetrosis is a bone change that occurs at approximately 80 years of age and is
referred to as:
a-avascular matrix with empty lacunae
b-harder and more brittle bone
c-hypermineralized bone continues to accumulate minerals
d- all of the above
40- regarding the force exerted to the bone, the bone can withstand better the ––––––––
force but poor for ____________________ force
a- tensile, shear
b- compressive, shear
c- shear compressive
d- tensile compressive
41- According to WOLFF’S law:

a- normal bone will adapt for any changes in the form and function
b- internal architecture or cancellous bone undergo adaptive changes (change in the
orientation of the trabecular bone)
c- external structure or cortical bone adapt to stress by increase in the density
d- disuse or bone stress reduction will cause in the bone mass loss
e- all of the above
42- The main biological difference between implants and natural teeth is:
a- periodontal ligament
b- vascular blood supply
c- connective tissue
d- junctional epithelium
e- all of the above
43- After tooth extraction and obliteration of the periodontal ligament, all of the
following are true except:
a- sensation
b- nutrition
c- trabicular bone
d- support
e- remodelling
44- For optimal soft tissue integration, implant therapy should be:
a- prosthetically driven
b- biologically driven
c- surgically driven
d- mechanically driven
e- anatomically driven
45- Regarding the thick gingival biotype, all of the following are true except:
a- respond to periodontal insult by recession
b- constitute approximately 85% of patients
c- characterized by thick band of keratinized gingiva
d- flat gingival appearance and lack scalloping
e- thickness >1.5mm
Biology 73
46- Regarding the thin gingival biotype, all of the following are false except:
a- ample keratinized gingiva
b- respond to periodontal insult by pocket
c- shorter distance between the crown contact area and crestal bone
d- found in triangular shape of teeth
e- constitute approximately 35% of patients
47- Alcohol has an adverse effect on mucosa and wound healing as it causes:
a- chemical burn
b- epithelial desquamative
c- epithelial fragility
d- wound contraction
e- all of the above
48- Cigarette and pipe smoking have adverse effects on wound healing and integrity. All
of the following are true except:
a- decrease tissue perfusion and oxygen delivery
b- create intraoral positive pressure causing a deleterious effect on wound healing
c- cause delayed wound healing and peri- implant infection
d- impaired gingival bleeding
e- increase oral cavity temperature
49- The purpose of platform switching is to allow the formation of the biological space
on the remaining platform of the implant, thereby decreasing crestal bone resorption. Platform
switching has no effect when the implant is placed in:
a- angulation
b- subcretal
c- thin biotype
d- supracrestal
e- c&d
50- Stable gingival margins are associated with all of the following except:
a- thick gingiva rather than thin gingiva
d- crown was formed with a convexity subgingivaly
c- adequate bone on the labial surface of the implant
d- good bone levels on the adjacent teeth
e- over correction of the gingival margin at the time of placement of the final restoration
CORRECT ANSWERS
Q1
e - all of above
Q2
a- 1.5mm and above
Q3
c- osteoclast activated from the osteoblast
Q4
b- implant placed adjacent to the nerve tissue
Q5
a- periosteal tissue
Q6
d- 47˚C
Q7
a- increase vertical periimplant bone resorption
Q8
d- a & c
Q9
b- 50 Gy
Q10
c- 24 months
Q11
d- resorption by osteoclasts (cutting cone), vascular loop formation with perivascular
osteoprogenitor cells, deposit concentric layers of lamellar bone by osteoblast
Q12
formation
Q13
osteogenesis
Q14
Q15
a- Directing bone formation at local osseous sites using membrane barrier techniques
Biology 75
Q16
d- All of above
17
b- Cell attachment and signalling
Q18
d- a & b
Q19
b- Hydroxyapatite binding
Q20
a- Regulation of cell function
Q21
a- Biologic control of bone turnover
Q22
c- Platelets/serum (osteoblast) and act as mitogenic
Q23
b- Serum, osteoblast or bone matrix and act as mitogenic
Q24
b- Endothelial cells/bone matrix and act as mitogenic, angiogenic
Q25
d- Osteoblast or bone matrix and act as regulates osteogenesis
Q26
a- Osteoblast or bone matrix and act as osteoinductive, regulates osteogenesis
Q27
b- alloplastic surface
Q28
a- contraction, epithelisation and connective tissue formation
Q29
d- haemostasis, inflammation, proliferation and remodelling
Q30
c- crater- like
Q31
d- a & b
Q32
d- all of the above
Q33
a- minimally rough Sa 0.5–1mm, moderately rough Sa 1–2mm and rough Sa >2mm
Q34
d- none of the above (moderately rough)
Q35
b- reduce hydrocarbon contamination
Q36
c- attenuates osteoblast activity (ALP activity reduced, calcium mineralization reduced)
Q37
c- alkaline phosphatase
Q38
a- osteoconductive
Q39
d- all of the above
Q40
b- withstand better the compressive force but poor for shear forces
Q41
e- all of the above
Q42
e- all of the above
Q43
c- trabicular bone
Q44
b- biologically driven
Q45
a- respond to periodontal insult by recession
Q46
d- found in triangular shape of teeth
Biology 77
Q47
e- all of the above
Q48
b- create intraoral positive pressure causing a deleterious effect on wound healing
Q49
e- c&d
Q50
d- crown was formed with a convexity subgingivaly
REFERENCES
Albrektsson T. The host- implant interface: biology. Int J Prosthod 2003;16 (Suppl.): 29–30;
discussion 47–51.
Albrektsson, T. & Wennerberg, A. (2004a) Oral implant surfaces: Part 1 – review focusing on
topographic and chemical properties of different surfaces and in vivo responses to them.
Int J Prosthod 2004a;17: 536–543.
Albrektsson, T. & Wennerberg, A. Oral implant surfaces: Part 1 – review focusing on
topographic and chemical properties of different surfaces and in vivo responses to them.
Int J Prosthod 2004a;17: 536–543.
Albrektsson, T. & Wennerberg, A. Oral implant surfaces: Part 2 – review focusing on clinical
knowledge of different surfaces. Int J of Prosthod 2004b;17: 544–564.
Ali A, Patton DW, El-Sharkawi AM, Davies J. Implant rehabilitation of irradiated jaws: a
preliminary report. Int J Oral Maxillofac Implants. 1997;12:523–6.
Boskey AL. Non collagenous matrix proteins and their role in mineralization. Bone Miner
1989;6:111-23., Stanford CM, Keller JC. The concept of osseointegration and bone
matrix expression. Crit Rev Oral Biol Med 1991;2:83–101.
Certosimo FJ, Nicoll BK, Nelson RR, Wolfgang M. Wound healing and repair: a review of
the art and science. Gen Dent 1998;46:362–9.
Chang YL, Lew D, Park JB, Keller JC. Biomechanical and morphometric analysis of
hydroxyapatite-coated implants withvaryingcrystallinity. J Oral Maxillofac Surg 1999;
57:1096–1108.
Cuesta-Gil M, Ochandiano Caicoya S, Riba-García F, Duarte Ruiz B, Navarro Cuéllar C,
Navarro Vila C. Oral rehabilitation with osseointegrated implants in oncologic patients. J
Oral Maxillofac Surg. 2009;67:2485–96.
Duyck J, Ronold HJ, Van Oosterwyck H, Naert I, Vander Sloten J, Ellingsen JE The
influence of static and dynamic loading on marginal bone reactions around
osseointegrated implants: an animal experimental study. Clin Oral Implants Res
2001;12:207–218.
Einhorn TA. Clinical applications of recombinant gene technology: bone and cartilage repair.
Cells Mater 1992;2:1–11.
Eriksson RA, Albrektsson T. The effect of heat on bone regeneration: an experimental study
in the rabbit using the bone growth chamber. J Oral Maxillofac Surg. 1984;42:705–11.
Fickl S, Zuhr O, Wachtel H, Bolz W, Huerzeler MB. Hard tissue alterations after socket
preservation: An experimental study in the beagle dog. Clin Oral Implants Res
2008;19:1111–1118.
Fickl S, Zuhr O, Wachtel H, Stappert CF, Stein JM, Hürzeler MB. Dimensional changes of
the alveolar ridge contour after different socket preservation techniques. J Clin
Periodontol 2008;35:906–913.
Freymiller EG, Aghaloo TL. Platelet-rich plasma: Ready or not? J Oral Maxillofac Surg
2004;62:484–488.
Frost HM “Wolff's Law and bone's structural adaptations to mechanical usage: an overview
for clinicians.” The Angle Orthodontist 1994;64:175–188.
Frost HM. Micropetrosis. J Bone Joint Surg 1960: 42A: 144–150.
Gehron-Robey P. The biochemistry of bone. Endocrinol Metab Clin North Am 1989;18:859-
902.
Goaslind GD, Robertson PB, Mahan CJ, et al. Thickness of facial gingiva. J Periodontol.
1977;48:768–771.
Goldring SR, Goldring MB. Cytokines and skeletal physiology. Clin Orthop 1996;324:13-23.
Gorska R, Gregorek H, Kowalski J, LaskusPerendyk A, Syczewska, M, Madalinski K.
Relationship between clinical parameters and cytokine profiles in inflamed gingival tissue
and serum samples from patients with chronic periodontitis. J Clinical Periodontol
2003;30:1046–1052.
Hayashi R, Ueno T, Migita S, Tsutsumi Y, Doi H, Ogawa T, Hanawa T, Wakabayashi N.
Hydrocarbone deposition attenuates osteoblast activity on titanium. J Dent Res. 2014
27;93:698–703.
Intini G. The use of platelet-rich plasma in bone reconstruction therapy. Biomaterials
2009;30:4956–4966.
Juliano RL, Haskill S. Signal transduction from the extracellular matrix. J Cell Biol
1993;120:577–85.
Linder L. Osseointegration of metallic implant I. Light microscopy in the rabbit. Acta Orthop
Scand 1989;60:129–34.
Lyndon F. Cooper Biologic determinants of bone formation for osseointegration: Clues for
future clinical improvements. J Prosth Dent 1998;80: 439–449.
Marx RE. Platelet-rich plasma: Evidence to support its use. J Oral Maxillofac Surg
2004;62:489–496.
Misch CE. Contemporary Implant Dentistry. St Louis, Mo: Mosby-Year Book; 2008, 3rd
edition.
Olsson M, Lindhe J. Periodontal characteristics in individuals with varying form of the upper
central incisors. J Clin Periodontol. 1991;18:78–82.
Owen TA, Holthuis J, Markose E, van Wijnen AJ, Wolfe SA, Grimes SR, Lian JB, Stein GS.
Modification of protein-DNA interaction on the proximal promoter of cell growth-
regulated histone gene during onset and progression of osteoblast differentiation. Proc
Natl Acad Sci U S A. 1990;87:5129–33.
Puzas JE. The osteoblast. In: Flavus MJ, editor. Primer on the metabolic bone diseases and
disorders of mineral metabolism. 2nd ed. Raven Press; 1993. p. 15–21.
Biology 79
Rodríguez X1, Vela X, Méndez V, Segalà M, Calvo-Guirado JL, Tarnow DP. The effect of
abutment dis/reconnections on peri-implant bone resorption: a radiologic study of
platform- switched and non- platform-switched implants placed in animals. Clin Oral
Implants Res. 2013;24:305–11.
Rupp F, Scheideler L, Olshanska N, de Wild M, Wieland M, Geis-Gerstorfer J. Enhancing
surface energy and hydrophilicity through chemical modification of microstructured
titanium implant surface. J Biomed Mater Res A. 2006;76:323–34.
Schenk RK, Buser D Osseointegration: a reality. Periodontology 2000;1998;17:22–35.
Stashenko P, Dewhirst FE, Peros WJ, Kent RL, Ago JM. Synergistic interactions between
interleukin 1, tumor necrosis factor, and lymphotoxin in bone resorption. J Immun
1987;138:1464–1468.
Steinemann, S.G. Metalimplantsand surface reactions. Injury 1996;27 (Suppl. 3): SC16–
SC22.
Stramandinoli-Zanicotti RT, Sassi LM, Schussel JL, Torres MF, Matos Ferreira SA, Carvalho
AL. Effect of radiotherapy on osseointegration of dental implants immediately placed in
postextraction sites of minipigs mandibles. Implant Dent. 2014;23:560–4.
Svehla M, Morberg P, Zicat B, Bruce W, Sonnabend D, Walsh WR. Morphometric and
mechanical evaluation of titanium implant integration: Comparison of five surface
structures. J Biomed Mater Res 2000;51:15–22.
Tanford CM, Keller JC. The concept of osseointegration and bone matrix expression. Crit
Rev Oral Biol Med 1991;2:83–101.
Tözüm TF, Demiralp B. Platelet-rich plasma: A promising innovation in dentistry. J Can
Dent Assoc 2003;69:664.
Touati B. Biologically driven implant treatment. Pract Proced Aesthet Dent 2003;15:734.
Wang JS. Basic fibroblast growth factor for stimulation of bone formation in osteoinductive
or conductive implants. Acta Orthop Scand Suppl 1996;269:1–33.
Zarb GA, Albretktsson T. Osseointegration: a requiem for the periodontal ligament? Int J
Periodont Rest Dent 1991;11: 88–91.
Zechner W, Tangl S, Tepper G, et al. Influence of platelet-rich plasma on osseous healing of
dental implants: A histologic and histomorphometric study in minipigs. Int J Oral
Maxillofac Implants 2003;18:15–22.
Chapter 6
RADIOLOGY
1- The initial radiograph of choice in dental implantology treatment is:

a- Computerised tomography
b- periapaical radiograph
c- cone beam CT
d- orthopantamogram
2- The lowest radiation dosage a patient can be exposed to is:

a- full mouth series of periapical radiographs
b- cone beam CT
c- orthopantamogram
d- Computerised tomography
e- a&c
3- The radiograph of choice for detailing of the morphology of both jaws close to the
midline is:
a- lateral cephalogram
b- periapaical radiograph
c- occlusal radiograph
d- orthopantamogram
e- a& c
4- For postimplant placement periapical radiographs, the correct angulation is easy to
verify when:
a- the thread profile is clearly seen
b- no overlapping with adjacent teeth
c- no radiolucency line between the bone and the implant thread
d- no elongation
e- all of the above
5- The difficulty with the periapical radiograph technique for implant registration is:
a- periapical region does not show
b- parallelism
c- elongation
d- cone cut
e- a & b
6- Peri- apical radiolucency in dental implants indicates:

a- infection
b- overheating
c- overdrilling
d- thining or perforation of the cortical plate
e- all of the above
7- The magnification of the orthopantomogram is not constant in one radiograph but

varies from one anatomical site to another. This is due to:
a- position of the head of the patient
b- variable distance between the object and the film and the distance between the object
and the source
c- angulation of the object
d- all of the above
8- To avoid burnout of the thin alveolar crestal bone during the assessment of periodontal
status, the operator should:
a- underexposed the film
b- the film should be over exposed
c- decreasing the developing time
d- increase the exposure dose
e- a & c
9- In panoramic radiographs, the normal anatomy shadow can be divided into real and
ghost shadows. The ghost shadow is:
a- orbital rim
b- nasal septum and chonchae
c- cervical vertebrae
d- zygomatic arch
e- floor of the antrum
10- Regarding the ideal quality criteria for the panoramic radiograph, all of the following
are true except:
a- the whole of the mandible should be included
b- magnification in the vertical and horizontal planes should be equal
c- the right and left molar teeth should be equal in their mesiodistal dimension
d- the image of the hard palate should appear with the level of apices of the upper teeth
e- no evidence of artefactual shadows due to dentures
Radiology 83
11- During periodontal tissue assessment, vertical bitewings are indicated when:
a- periodontal pocketing 6 mm and more
b- periodontal pocketing 8 mm and more
c- the apical region need to be shown
d- long root need to be evaluated
e- when teeth tilted lingualy
12- The main radiographic features of chronic osteomyelitis are:

a- moth- eaten area
b- sclerosis of the surrounding bone
c- radiopaque sequestra
d- involucrum
e- all of the above
13- The main radiographic features of osteoradionecrosis include all of the following
except:
a- moth- eaten radiolucency
b- radiopaque sequestra
c- subperiosteal involucrum bone formation
d- undefined margin between necrotic and normal bone
e- c&d
14- The main radiographic features of bisphosphonate- related osteonecrosis are:

a- diffuse sclerosis of the bone
b- thickening of the lamina dura
c- moth- eaten
d- radiopaque sequestra
e- a&b
15- The main radiographic features of hyperthyroidism are:

a- irregularity of the cortical bone
b- teeth root resorption
c- loss of lamina dura
d- cotton wool bone appearance
e- a&b
16- The radiographic features of late- stage Paget’s disease are:

a- loss of lamina dura
b- alveolar bone enlarge and distorted
c- cotton wool patches appearance
d- bone formation appear inside the sinuses
e- all of the above
17- Regarding maxillary sinuses, the best radiograph to show the floor of the sinus is:
a- periapical
b- panoramic
c- occipitomental
d- antero- postrior skull view
e- a&b
18- Regarding maxillary sinuses, the best radiograph to show the lateral wall and roof of
the sinus is:
a- periapical
b- panoramic
c- occipitomental (0o OM)
d- antero- postrior skull view
e- a&b
19- Bone saucerization around the dental implant shoulder has two dimensions
(horizontal and vertical). Usually radiographs demonstrate:
a- vertical aspect, but horizontal shifted radiograph can demonstrate the horizontal aspect
as well
b- horizontal aspect
c- vertical aspect
d- horizantal and vertical aspect
20- Cone beam computerized tomography (CBCT) provides three- dimensional images
with high resolution relative to two- dimensional image for dental implant usage. The level of
detail available with CBCT may be needed for:
a- 200- 300µm
b- 300- 400 µm
c- 400- 500 µm
d- 50- 100 µm
e- 600- 800 µm
21- The advantage of using the long cone beam technique in periapical radiographs is:
a- decrease the exposure time
b- decrease heat generation
c- minimize cone cut error
d- decrease magnification and angulation error
e- all of the above
22- Which of the following views can be achieved with cone beam computerized
tomography (CBCT):
a- periapical radiograph
b- orthopantamogram
c- cephalogram
d- tomography
e- all of the above
Radiology 85
23- Voxel is related to:

a- surface area of the cell
b- volume of the cell in three dimensional image
c- radiation intensity
d- field of view
24- Three- dimensional radiographs can be used in the fabrication of:

a- sterogram
b- prosthesis framework
c- surgical stent
d- diagnostic stent
e- all of the above
25- Peri- implant bone resorption will show as radiolucency. This radiographic changes
when the bone density decreases
a- 40%
b- 10%
c- 20%
d- 5%
e- 30%
CORRECT ANSWERS
Q1
d- orthopantamogram
Q2
c- orthopantamogram
Q3
a- lateral cephalogram
Q4
a- the thread profile is clearly seen
Q5
e- a & b (implant placed below tooth apex, located beyond muscle attachment)
Q6
e- all of the above
Q7
d- all of the above
Q8
a- underexposed the film
Q9
c- cervical vertebrae
Q10
d- the image of the hard palate should appear with the level of apices of the upper teeth
Q11
a- periodontal pocketing 6 mm and more
Q12
e- all of the above
Q13
e- c&d
Q14
e- a&b
Q15
c- loss of lamina dura
Q16
e- all of the above
Q17
e- a&b
Q18
c- occipitomental (0o OM)
Q19
b- horizontal aspect
Q20
a- 200- 300 µm
Q21
d- decrease magnification and angulation error
Q22
e- all of the above
Radiology 87
Q23
b-volume of the cell in three dimensional image
Q24
e- all of the above
Q25
a- 40%
REFERENCES
Floyd P, Palmer P, Palmer R Radiographic techniques. Br Dent J. 1999;187:359–65.
Jivraj S, Chee W Treatment planning of implants in the aesthetic zone. Br Dent J.
2006;201:77–89.
Piattelli A, Piattelli M, Mangano C, Scarano A A histologic evaluation of eight cases of failed
dental implants: is bone overheating the most probable cause? Biomaterials.
1998;19:683–90.
Piattelli A, Scarano A, Piattelli M, Podda G. Implant periapical lesions: clinical, histologic,
and histochemical aspects. A case report. Int J Periodontics Restorative Dent.
1998;18:181–7.
Piattelli A, Scarano A, Piattelli M. Abscess formation around the apex of a maxillary root
form implant: clinical and microscopical aspects. A case report. J Periodontol.
1995;66:899–903.
Whites E, Drage N, Essential of Dental Radiography and Radiology, Churchill livingstone
Elsevier, 5th edition, 2013.
Chapter 7
MISCELLANEOUS
1- The factor that can determine the alignment of teeth in a dental arch is:
a- arch shape
b- tooth size
c- eruption time
d- masticatory load
e- a&c
2- Trigeminal neuralgia manifestation is:

a- usually affecting maxillary and mandibular division nerve more than ophthalmic
b- more common in 5th and 6th decades of life
c- pain can be initiated by putting makeup or tooth brushing
d- treated pharmacologically with anticonvusants drugs
e- all of the above
3- A network of valveless veins allows the migration of septic thrombi from the sinus to
the cavernous sinus. All of the following are true regarding the cavernous sinus thrombosis
except:
a- periorbital edema due to venous congestion
b- exophthalmos
c- affects cranial nerve II
d- affects cranial nerve III
e- Ophthalmoplegia
4- Bell’s palsy is unilateral facial paralysis from facial nerve damage. All of the
following are true regarding Bell’s palsy except:
a- during smiling the mouth draws to the affected side
b- patient cannot wink, close eyes on the affected side
c- food accumulate btween the teeth and the check in the affected side
d- hyperacusia
e- loss of taste in the anterior tongue
5- Xerostomia or dry mouth can be caused by all the following except:

a- some medication, like antihistamine, antihypertensive, antidepressant
b- diseases like, stress, Sjögren’s syndrome and endocrine disorder
c- radiotherapy in head and neck area
d- citric juice consumption
6- Allergies and infections adjuvant to structural abnormalities will lead to the

obstruction of the maxillary sinus ostia (opening), which can in turn lead to:
a- anoxia (decrease O2 in sinus)
b- mucosal edema
c- mucosal fluid leakage
d- decrease mucociliary clearance
e- all of the above
7- When an emergency airway is needed, cricothyrotomy is performed by making an

incision through:
a- cricothyroid muscle
b- cricothyroid membrane
c- cricothyroid cartilage
d- cricothyrpoid joint
8- Attrition is the loss of tooth substance from wear due to:

a- bruxism (grinding and clenching)
b- lack of posterior support and occlusal collapse
c- citrus fruits
d- traumatic tooth brush
e- a&b
9- Hypoglycemia in diabetic patients during dental treatment can occur because of:
a- excess insulin
b- missing a meal
c- stress
d- changing insulin dose and regime
e- all of the above
10- Signs and symptoms of hypoglycemia include:

a- slow onset
b- dry skin
c- irritable behaviour
d- rapid breathing
e- c&d
Miscellaneous 91
11- The drug and dose of choice for unconscious hypoglycemic patients is:
a- 50 ml of 50% glucose IV
b- 1mg glucagon IM
c- 100 ml of 50% glucose IV
d- 10 mg glucagon IM
e- a & b
12- During an adrenal crisis for patient with long- term corticosteroid use, the drug of
choice is:
a- 200mg hydrocortisone IV
b- 40mg prednisolone orally
c- dexamethasone 0.75mg IM
d- betamethasone 0.75mg IM
e- a&c
13- Status epilepticus in an epileptic patient means:

a- desire to sleep
b- rigid and extended body
c- jerking body movement
d- prolong or repeated fit
e- all of the above
14- Involucrum refers to:

a- occur in chronic osteomyelitis
b- new bone growth outside existing bone
c- stripping off of the periosteum
d- new bone growing from the periosteum
e- all of the above
15- According to the American College of Surgeons’ wound classification, dental implant
surgical wounds are under:
a- clean (infection rate <2%)
b- clean contaminated (infection rate 10- 15%)
c- contaminated (infection rate 20- 30%)
d- dirty/infected (infection rate 50%)
16- An INR of 1 indicates a healthy person. The acceptable INR for minor oral surgery
for a patient taking anticoagulants is 2.5. A reading of 3.5 may still be acceptable when the
patient is at high risk for stopping the anticoagulant drug, such as a patient suffering from:
a- history of cerebrovascular accident
b- myocardial infarction patient
c- proshetic heart valve
d- venous thrombosis
e- c&d
17- Which type of bacteria can inhibit osteoblast alkaline phosphatase activity and
negatively affect bone formation?
a- Influenza
b- staphelo cuccus aureus
c- Prevotella intermedia(Pi)
d- strpteo cuccus mutans
e- actino bacter
18- Viral contamination could affect osteogenesis by initiating:

a- bone resorption
b- vascular injury
c- wound dehiscence
d- fibrous tissue
e- bleeding
19- A failing implant has an increase of periodontal pathogens that initiate pocketing,
such as:
a- prevotella intermedia & Porphyromonas gingivalis,
b- streptococcus mutans
c- staphylococcus aureus
d- aggregatibacter actinomycetemcomitans
e- a&d
20- Factors that may affect the quantity and type of bacteria in the oral cavity are:
a- time
b- edentulous condition (complet vs partial)
c- pocket depth
d- implant neck surface
e- all of above
21- The main bacteria responsible for sinusitis infections is:

a- actino bacter
b- haemophilus influenza
c- streptococcus pneumonia
d- staphylococcus
e- b&c
22- Connective tissue destruction can be observed as early as 3 to 4 days after plaque
accumulation. Cells that are mainly responsible for collagen fiber destruction include:
a- fibroblast
b- polymorphonuclear lymphocytes
c- neutrophil
d- macrophages
e- b& d
Miscellaneous 93
23- The C- terminal telopeptide (CTX) is used as a biomarker in the serum to measure the
rate of:
a- calcium ion deposition in the bone
b- bone remodeling
c- Bone mineralization
d- alkaline phosphatase secretion
e- a&c
24- Serum levels of the C- terminal telopeptide (CTX) in healthy patients not taking
bisphosphonates are usually above:
a- 100pg/ml
b- 200 pg/ml
c- 300 pg/ml
d- 150 pg/ml
e- 50 pg/ml
25- To improve the serum levels of the C- terminal telopeptide (CTX) for patient taking
bisphosphonates who need bone surgery, a “drug holiday” is recommended. This means:
a- stop the drug for one year starting one month before the surgery
b- stop the drug 6 weeks before surgery and 6 weeks after
c- stop the drug 3 months before surgery and 3 months after
d- stop the drug 6 month before the surgery and continue after
e- decrease the drug dose into half
26- The international normalized ratio (INR) measures:

a- extrinsic pathway of coagulation
b- extrinsic pathway and common pathway of coagulation
c- intrinsic pathway of coagulation
d- intrinsic pathway and common pathway of coagulation
27- All of the following are causes of crestal bone resorption around natural teeth except:
a- bruxeser patient
b- cervical caries
c- periodontal disease
d- fracture roots
e- maligned tooth
CORRECT ANSWERS
Q1
d- masticatory load ( masticatory load are within physiological range and act through the
long axis of as many teeth in the arch as possible, royal college of surgeon)
Q2
e- all of the above
Q3
c- affects cranial nerve II (it is not the content of the cavernous sinus)
Q4
a- during smiling the mouth draws to the affected side (to the unaffected site)
Q5
d- citric juice consumption
Q6
e- all of the above
Q7
b- cricothyroid membrane
Q8
e- a&b
Q9
e- all of the above
Q10
e- c&d
Q11
e- a & b
Q12
a- 200mg hydrocortisone IV
Q13
d- prolong or repeated fit
Q14
e- all of the above
Q15
b- clean contaminated (infection rate 10- 15%)
Q16
e- c&d
Miscellaneous 95
Q17
c- Prevotella intermedia(Pi)
Q18
b- vascular injury
Q19
e- a&d
Q20
e- all of above
Q21
e- b&c
Q22
e- b& d
Q23
b- bone remodelling
Q24
c- 300 pg/ml
Q25
c- stop the drug 3 months before surgery and 3 months after
Q26
b- extrinsic pathway and common pathway of coagulation
Q27
a- bruxeser patient
REFERENCES
Becker W, Becker BE, Newman MG, Nyman S. Clinical and microbiologic findings that may
contribute to dental implant failure. Int J Oral Maxillofac Implants 1990;5:31–8.
Chestnut IG, Gibson j, Churchill’s Pocketbook of Clinical Dentistry, Churchill Livingstone,
London, 1998.
Gao SZ, Hunt SA, Schroeder JS, Alderman EL, Hill IR, Stinson EB. Early development of
accelerated graft coronary artery disease: Risk factors and course. J Am Coll Cardiol
1996;28:673–679.
Kanai K, Kuwabara S, Mori M, Arai K, Yamamoto T, Hattori T. Leukocytoclastic-vasculitic

neuropathy associated with chronic Epstein-Barr virus infection. Muscle Nerve
2003;27:113–116.
Murata T, Ansai T, Takehara T, Kobayashi S, Haneji T. Extracts of Prevotella intermedia and
Actinobacillus actinomycetemcomitans inhibit alkaline phosphatase activity in
osteoblastic cells in vitro. Oral Dis 1997;3:106–112.
Neil s. Norton Netter’s head and neck anatomy for dentistry, 2nd edition, Elsever,
Philadelphia, 2012.
Payne WA, Page RC, Ogilvie AL, Hall WB. Histopathologic features of the initial and early
stages of experimental gingivitis in man. J Periodontal Res 1975;10:51–64.
Whites E, Drage N, Essential of Dental Radiography and Radiology, Churchill Livingstone
Elsevier, 5th edition, 2013.
SECTION TWO: CLINICAL SCIENCE
Chapter 8
SURGICAL
1- The literature has shown that compared with conventional socket healing, post-
extraction alveolar bone remodeling can be ____________ by some alveolar ridge
preservation procedures:
a- completely inhibited
b- significantly reduced, but not completely inhibited
c- significantly Increased
d- adversely affected
2- Expansion techniques after tooth extraction lead to:

a- significant socket shrinkage
b- socket increase in volume
c- complete socket preservation
d- limit socket resorption
e- b&c
3- Postextraction bone volume changes occur mostly during the ____________ months
immediately after extraction, but it has been reported in the literature that remodeling
continues for up to ____________ months:
a- 1st month, 6 month
b- 2 month, 8 month
c- 6 month, 9 month
d- 3 month, 12 month
4- After tooth extraction, alveolar bone resorption will be:

a- Not affected
b- Increased progressively towards the apical level
c- Same rate at the apical and coronal level
d- decreased progressively towards the apical level
5- All of the following are relative contraindications for sinus floor elevation except:
a- sinus floor convolutions
b- sinus septum
c- tumor
d- transient mucosa swelling
e- narrow sinus
6- Plain cut gut is a resorbable suture material that needs ____________ to resorb:
a- one week
b- 2 weeks
c- 4 weeks
d- 6 weeks
e- 8 weeks
7- Chromic cut gut is a resorbable suture material that needs ____________ to resorb:
a- One week
b- 2 weeks
c- 4 weeks
d- 6 weeks
e- 8 weeks
8- Vicryl is a braded resorbable suture material that needs ____________ to resorb:

a- One week
b- 2 weeks
c- 4 weeks
d- 6 weeks
e- 8 weeks
9- Nylon is a monofilament suture that is more hygienic and traumatic when used in
dental implant surgery, but there are disadvantages to its use, including:
a- need skill to perform
b- need at least 5 knot to get secure knot
c- irritant to the patient
d- has memory (spring action)
e- all of above
10- Black silk is a braded suture material that is not highly recommended for use in
dental implant procedures because:
a- low tensile strength
b- resorbable
c- need special skills
d- cause allergic reaction
Surgical 101
11- Polytetrafluroethylin (PTFE), or Teflon, is the most recommended suture material for
use in dental implant procedures, but some operators avoid using it because:
a- flake
b- irritant to the patient
c- need long time to resorb
d- cost
12- In cases of bone grafting and a GBR procedure, optimum flap closure is needed until
the soft tissue is completely healed. The suture material of choice is:
a- black silk
b- Teflon
c- Vicryl
d- Chromic cut gut
e- Nylon
13- For successful implant placement, the proportion of residual BioOss material after
socket preservation is:
a- 40%
b- 20%
c- 60%
d- 10%
e- 70%
14- After maxillary sinus membrane elevation, there will be membrane changes, such as:
a- membrane thinning
b- decrease blood supply
c- decrease in the ciliary and washing action
d- membrane thickening
e- c&d
15- Absolute contraindications for sinus floor elevation are maxillary sinus diseases
(tumors) and:
a- smoker patient
b- destructive former sinus surgery (like the Caldwell–Luc operation)
c- active infection
d- narrow sinus
e- all of the above
16- Nontraumatic extraction followed by implant stabilization in the extraction socket is

commonly achieved over:
a- the last 5 mm of the implant apical region
b- the last 3 mm of the implant apical region
c- the coronal half of the socket
d- apical half of the socket
17- The level of implant platform placement is:

b- bone driven
c- surgical driven
d- biological driven
18- The risk of placing a dental implant in HIV positive patient is from:
a- bleeding
b- infection
c- delay healing
d- all of the above
19- For flap suturing, tissue trauma may be reduced by selecting:

a- finer suture diameters
b- thicker suture diameters
c- surgical knot to make the knot
d- matress suture technique
e- c&d
20- The horizontal soft tissue incision in the posterior maxillary edentulous area should
be slightly palatal, which will offer:
a- better view of the alveolar ridge
b- more keratinized gingival tissue
c- inclusion of palatine blood vessels in the wound healing process
d- all of the above
21- When the lingual artery is injured during implant placement in the lower anterior
area, immediate management includes:
a- pulling the tongue outside patient mouth
b- finger pressure on the lingual side
c- clamp the artery and ligate it
d- put haemostatic agent on the lingual flap
e- b&d
22- During implant placement in the posterior maxillary area, the apex of the implant
may engage the maxillary sinus floor. This will lead to:
a- decrease implant stability
b- over countersink
c- increase implant stability
d- infection
e- a&d
Surgical 103
23- During implant placement in the posterior maxillary area, the implant may
accidentally penetrate the maxillary sinus within 2 to 3 mm. The healing tissue formation
around the implant could be either soft tissue formation or an infection around the apex of the
implant with:
a- sinus membrane thickening
b- bone formation from bone edge and covering the implant apex
c- periostruim will grow and cover the apex
d- polyp tissue formation
e- c&d
24- When an implant is placed in the mandibular posterior area, the distance from the
inferior alveolar nerve should be 2 mm because:
a- mandibular jaw angulation make the nerve nearer to the crest
b- the apex of the drill (1.5) not estimated in most implant system
c- anatomical variation
d- allow the implant to be placed with angulation
e- a&c
25- Socket stretching refers to:

a- expand the socket with expander
b- fructure the buccal plate after tooth extraction to widen the socket
c- make second hole adjacent to the primary hole drilling within 1- 2mm
d- place wide diameter implant than the socket preparation osteotomy
26- The disadvantage of a tooth- supported surgical stent in a single anterior implant is:
a- not stable enough
b- no sufficient space for the drills
c- difficult to determine the drilling depth
d- obscure the adjacent anatomical teeth structures
e- b&c
27- During a single implant placement in upper anterior area, the implant apico- coronal
placement should be:
a- 3mm from the ginigival margin
b- 4 from the cemento- enamel junction
c- 2mm from the cemento- enamel junction
d- 2mm from the gingival margin
e- a&c
28- The proper position of the implant during immediate placement in the upper anterior
socket is:
a- palatally placed but labially angulated
b- palatelly placed but parallel to the labial wall
c- in the mid of the socket and parallel to palatal and labial walls
d- parallel and engaging the palatal wall
29- When an implant will be placed in hard, dense bone, which implant should be chosen
to avoid pressure necrosis:
a- wide diameter implant
b- aggressive implant design
c- regular diameter implant
d- none tapered implant (parallel wall)
e- c&d
30- After implant placement, the most significant drop in implant stability occurs after:
a- 6 weeks
b- 1 week
c- 3- 4 weeks
d- 2 weeks
31- The flapless punch technique is recommended for regular- size implants when the
minimum ridge width:
a- 7mm
b- 8 mm
c- 6 mm
d- 5 mm
32- When the lateral widow approach is used for maxillary sinus elevation, the operator
relies on a 3- mm perforation of the Schneiderian membrane. The best management approach
in this situation is:
a- autogenous cortical plate should be placed before particulate bone graft
b- collagen membrane barrier place underneath the membrane
c- suturing should be done to close the opening with resorbable suture
d- stop the operation and postponed to another time until the membrane healed
Surgical 105
33- Ahigh incidence of Schneiderian membrane peroration with a lateral approach occurs
during:
a- membrane elevation
b- lateral window drilling osteotomy
c- fracturing the lateral widow
d- collagen membrane placement
e- b&c
34- Simultaneous implant placement and sinus augmentation is not recommended when:
a- using xenograft as a graft material
b- regular size implant is used
c- bone height underneath the maxillary sinus is <5
d- soft bone
e- a&d
35- During a socket preservation procedure, the following should be considered:

a- no active infection
b- graft should be placed with layering
c- no condensation should be done to the graft material
d- no over grafting
e- all of the above
36- The treatment plan of choice for grossly decayed, unsolvable, upper central incisors
with an optimal tissue condition is:
a- socket preservation with GBR procedure
b- the socket should be left for normal healing and delay implant placement
c- composite graft procedure needed
d- immediate implant placement with immediate crowning
37- During a nonsubmerged procedure, there may be gingival overgrowth above the
healing abutment during soft tissue healing. This can be treated with:
a- scalpel excision
b- laser excision
c- replace the healing abutment with longer one
d- replace the healing abutment with wider one
38- Three weeks after submerged implant placement, you notice wound dehiscence and
that part of the cover screw is exposed. What is the best management approach in this case?
a- no treatment need, leave it for spontaneous healing
b- GBR procedure needed
c- full exposure of the cover screw and healing abutment placed
d- resuturing and complete closure
39- The main cause of cover screw exposure during the healing period is:
a- implant placed more buccally
b- crestal bone resorption
c- infection
d- thin gingival tissue
e- a&c
40- The most convenient and least traumatic scalpel that can be used in implant dentistry
for narrow spaces is number:
a- 20
b- 15
c- 11
d- 12
41- An osteotensor is:

a- result of the rapid accelerating phenomena (RAP)
b- bone expansion before implant placement
c- subperiosteal blade implant placement in atrophied mandible
d- bone formation underneath the periosteum
42- Athorough investigation of the upper posterior edentulous area is needed to determine
the bone volume availability before implant placement because:
a- difficult to determine the bone angulation in this area
b- thick gingival tissue can mask the bone volume
c- most of the time the soft tissue does not follow bone resorption
d- poor bone density can resorbed easily
e- b&c
43- One of the major problems in using internal irrigation during bone osteotomy
preparation is:
a- obscure the surgical field view with irrigants before starting
b- the burs thrusted easily
c- difficult to control the amount of the irrigation
d- blockage of the irrigation holes with debris
44- The implant should be submerged when:

a- poor primary implant stability
b- soft tissue grafting
c- bone grafting
d- esthetic purposes
e- all of the above
Surgical 107
45- When collagen membrane is placed in the edentulous area adjacent to natural teeth, it
should be away from the adjacent roots because:
a- cementum will enhance early membrane resorption
b- infection and contamination through the root surface
c- membrane mobility will occur
d- difficult to adapt the membrane on rounded surfaces
46- The disadvantage of the punch flapless technique is:

a- kertinized tissue loss
b- blind technique
c- difficult to determine implant position in bone level implant
d- difficult to change drilling position or angulation
e- all of the above
47- The drawback of manual implant placement relative to motor placement is:
a- slow
b- contamination from the adjacent tissue
c- difficult to control implant placement angulation due to uncontrolled force
d- no irrigation during implant placement
48- The operator may be unable to place the implant level with bone or countersink it
because:
a- underdrilling of the implant socket
b- debris at the apical part of the socket, failed to wash out
c- crestl preparation not done for the tapered implant
d- bone taping not used in hard bone
e- all of the above
49- After the healing period, the best noninvasive method to verify secondary implant
stability and osseointegration of the implant is:
a- resonance frequency analysis
b- reverse torque
c- periotest
d- implant percussion
e- all of the above
50- For a tissue- level implant with a smooth collar, it is always recommended to place
the implant above the bone because:
a- to get proper biological width
b- to place implant –abutment junction away from the crestal bone
c- smooth surfaces will exert shear forces to the bone that enhance crestal bone resorption
d- to allow more soft tissue attachment to the smooth collar
e- a&b
51- To increase the primary stability of an implant placed in soft bone, which of the
following should be considered:
a- undersize drilling
b- wide diameter implant
c- subcrestal placement implant
d- deep threaded implant, with the thread until the top
e- all of the above
52- To gain ridge width in the lower posterior area with minimum vertical bone
resorption, all of the following procedures can be performed except:
a- bone height reduction
b- later bone augmentation
c- ridge splitting
d- nerve lateralisation
53- Factors that can prevent placement of the implant in an ideal position include:
a- bone quality
b- anatomical factor
c- occlussion factor
d- implant position in the arch
54- When placing an implant immediately after tooth extraction in the upper anterior
area, there will be gap distance or jumping distance between the implant surface and the labial
wall of the socket. This distance should be filled by bone graft particles to prevent:
a- soft tissue formation around the implant
b- implant tilting towards the labial side
c- collapse of the labial wall of the socket in towards the implant surface
d- gingival soft tissue collapse into the socket
55- According to the Lechom and Zarb classification, which type of bone needs bone
taping before implant placement:
a- type I
b- type II
c- type III
d- type IV
e- a&b
56- To avoid bone overheating during drilling, the following should be considered:
a- use internal irrigation
b- use sharp drills
c- incremental drilling procedure with increasing diameter drills
d- continuous drilling
e- b&c
Surgical 109
57- To achieve a proper emergence profile and to avoid a ridge overlap, an implant in the
upper incisors should be placed bucco- lingually in:
a- underneath the cingulum
b- between the cingulum and the incisal edge
c- more palataly
d- slightly labial to the incisal edge
58- Generally, the final bone preparation socket diameter is slightly smaller than the
implant diameter because:
a- 1mm
b- 0mm (same diameter)
c- 0.6mm
d- 0.2mm
59- The advantage of increasing the implant length compared to increasing the diameter
is:
a- bi- cortical engagement
b- more bone implant contact
c- more bone compression on soft bone
d- decrease the stress on the crestal area
60- The best management for wound dehiscence after a GBR procedure and exposure of
the resorbable collagen membrane to the oral cavity is:
a- antibiotic prescription, maintain good oral hygiene, special care to the exposed
membrane by Chlorhexiden irrigation and removal of the plaque from the membrane
b- no management needed, just wait for wound to close spontaneously
c- remove the collagen membrane and replace by new one
d- resuturing the dehiscence with complete closure
61- In cases of a GBR procedure, the best suturing technique to achieve complete closure
and hold the wound in contact during soft tissue healing is:
a- figure 8
b- vertical mattress with simple interrupted suture in between
c- simple continuous
d- continuous block
62- Implants placed in the mandible are exposed and loaded earlier than those in the
maxilla (approximately 3 months vs. 6 months) because:
a- poor bone quality of the maxilla
b- high bone density on the mandible
c- mandibular implant engage with more cortical bone that give more support
d- bone implant contact on the mandible is higher than the maxilla
e- all of the above
63- In cases with a hybrid prosthesis in a high smile- line patient, the transitional area
shows when smiling. The best management approach in such a case is:
a- upper lip lengthening
b- soft tissue augmentation to mask the transitional area
c- vertical bone augmentation and change the prosthesis into fixed prosthesis with ideal
condition
d- vertical reduction of the ridge and flange can be add to prosthesis to mask the
transitional area
e- c&d
64- Implants placed in the anterior of the mandible can be immediately loaded with a
provisional complete prosthesis because:
a- dense bone give support to the implant
b- bi- cortical engagement
c- the implants can be splinted together
d- immediate osseointegration of the implant to the surrounding bone
e- all of the above
65- during implant placement in the upper first premolar area, special consideration
should be given to:
a- curved apex of the adjacent canine
b- maxillary sinus
c- mesial curvature of the second premolar root
d- distal root angulation of the adjacent canine
e- a&d
66- Underestimating the size of the incisive foramen in the upper central area during
implant placement leads to implant engagement to the foramen, which in turn leads to:
a- numbness of the gingival premaxilla
b- soft tissue formation on the surface of the implant from the foramen
c- infection may spread to the nose
d- sever bleeding
e- a&d
Surgical 111
67- Due to limited space in the upper central area, the implant may need to be placed in
the incisive foramen. The best management approach in this case is:
a- enamoplasty with orthodontic movement to adjacent teeth to create space
b- evacuation of the foramen content then implant place in the foramen
c- evacuation of the foramen content, bone grafting then implant placed after graft
healing
d- place the implant more labial with labial bone grafting
e- b&c
68- When autogenous bone is needed for one implant, the intraoral harversian donor site
is:
a- symphysis
b- external oblique ridge
c- tuberosity
d- exostosis
e- all of the above
69- The drawbacks of an intraoral- harvested bone graft include all of the following
except:
a- more morbidity to the patient
b- need special skill and training
c- nerve and teeth injury may occur
d- need hospital admitting
e- with restriction for medically compromised and depleted patient
70- The disadvantages of the sinus lift crestal approach include all of the following
except:
a- sinus my perforate without the knowledge of the operator
b- may cause vertigo
c- not advocated in medically compromised patient
d- blind procedure
e- give minimal sinus left
71- Due to sensory nerve injury, the patient will experience an oversensation of normal
nerve stimulation, which is called:
a- hyperaesthesia
d- anaesthesia
c- paraesthesia
d- dysesthesia
72- Structural nerve damage without complete nerve cutting is called:

a- neurotemesis
b- neuroparaxia
c- axontemesis
d- neurogenesis
73- In cases of neuropraxia, the estimated recovery time is:

a- 6- 8weeks
b- 8- 16 weeks
c- 4- 6 months
d- 1- 2 weeks
e- 6- 12 months
74- A late superficial postoperative infection of soft tissues in submerged implant can be
caused by:
a- retained piece of suture material
b- insufficient tightening of the cover screw, or interfere of the soft tissue between the
cover screw and the implant Wound dehiscence
c- Osseointegration failed to form
d- a&b
75- To identify mobile implants at the abutment connection using a reverse- torque test,
the force should not exceed:
a- 5Ncm
b- 10Ncm
c- 20Ncm
d- 25Ncm
76- To decrease stress on the crestal bone, the following should be considered:
a- smooth collar implant should not place subcrestaly
b- choose wide diameter implant
c- avoid subcrestaly placed implant in dense bone, may lead to over torque the implant
d- try to avoid angulated implant placement
e- all of the above
77- A short implant should be avoided in which of the following cases:

a- dense bone
b- compromised patient
c- soft bone
d- bruxuser patient
e- c&d
Surgical 113
78- For a patient with gingival recession on the adjacent teeth to the edentulous area, the
best flap design is:
a- vestibular incision
b- papillae preservative incision
c- crestal with intrasulcular incision including the papillae
d- three sided flap including the papillae
79- Immediate implant loading is determined when:

a- implant placed torque more than 35Ncm
b- implant placed in dense hard bone
c- resonance frequency analysis is 75 ISQ and above
d- when multiple implants splinted together
e- all of the above
80- The advantages of flapless punch implant placement include all of the following
except:
a- indicated when limited keratinized tissue found
b- less bleeding during surgery
c- time saving
d- less pain and oedema postoperatively
e- no suture needed
81- The advantages of the nonsubmerged over the submerged technique for implant
placement include all of the following except:
a- no need for second surgery
b- soft tissue maturation and formation around healing abutment
c- can be carried out with flap and flapless technique
d- more preferred in the aesthetic area
e- can transmit some of stress to the surrounding bone that enhance bone maturation
82- The following is needed in bone grafting:

a- intimate contact between the graft and the recipient site
b- blood supply
c- infection free in the grafted site
d- complete soft tissue coverage
e- all of the above
83- Graft immobilization or fixation is crucial during a bone grafting procedure because:
a- graft mobility allow soft tissue growth
b- graft mobility cause wound opening and dehiscence
c- graft mobility prevent blood vessels sprouting into the graft material
d- graft mobility enhance inflammation and interleukin- I
84- During bone grafting, the blood vessels interring the graft site (angiogenesis) should
only be from bone because:
a- blood vessels originated from the bone carrying the osteoblast progenitor cells
b- blood vessels originated from the bone site is growing faster than soft tissue one
c- blood vessels originated from the soft tissue usually carry osteoclast cells
d- blood vessels originated from the soft tissue is usually prevented by the collagen
membrane
85- For a better emergent profile of an implant placed in the upper premolar area, the
implant should be placed:
a- under the central fossa
b- under the buccal cusp
c- under the palatal cusp
d- subcrestal at least 1mm
86- The disadvantages of the partial thickness flap include all of the following except:
a- flap perforation during reflection
b- thinning of the flap tissue
c- delay healing
d- cause diminish blood supply to the surrounding bone
e- cause more oedema postoperatively
87- The advantage of an H- incision is:

a- can explore the anatomical area
d- good flap adaptation in soft tissue grafting
c- minimal invasive with blood supply preservation
d- provide wide surgical view
e- a&d
88- To enhance soft tissue thickening around a dental implant, the following procedure
can be performed:
a- connective tissue grafting
b- subperiostel alloplast bone grafting
c- apical repositioning flap
d- alloderm grafting
e- a&d
89- A hydrophylic implant surface shortens the healing period by:

a- early attachment of the blood clot
b- act as osteoinduction
c- increase implant surface area
d- decrease the gap between implant and bone
e- b&c
Surgical 115
90- What is the anatomical finding that increases the incidence of maxillary sinus
membrane perforation during a sinus lift procedure?
a- thin lateral bony wall
b- narrow medio- lateral space of the sinus
c- scaloped shape of the sinus floor
d- sinus septae
e- a&c
91- One of the unfavorable changes for the operator after extraction of upper molars is:
a- tuberosity enlargement
b- pneumatisation
c- vertical bone resorption
d- thickening of the gingival tissue
e- all of the above
92- The following complication is expected when an implant is placed in a patient who
has not yet reached puberty:
a- change implant angulation due to bone growth
b- under developed alveolar bone at implant site due to ankyloses
c- implant sinking due to bone growth
d- crown spacing
e- c&d
93- Placing an implant in soft bone is usually associate with an increased failure rate. To
reduce implant failure, which of the following should be considered:
a- increase implant length and width
b- increase the number of the implant
c- cantilevers should be omitted
d- reduce implant crown height and width
e- all of the above
94- A late implant failure usually occurs because of mechanical problems or an

overloaded implant. The best management approach in this case is:
a- trephine bure used to remove the implant, followed by immediate implant placement
with long implant
d- trephine bure used to remove the implant, followed by complete closure of the soft
tissue, fixed or removable prosthesis fabricate instead of implant after soft tissue
healing
c- trephine bure used to remove the implant, followed by bone grafting with GBR
procedure, late implant placement after bone grafting healing
d- trepine bure used to remove the implant, followed by immediate implant placement
with wide diameter implant
95- During a second- stage surgery and when the abutment connection is healing, the
patient experiences pain, and there is slight implant mobility. The best management approach
is:
a- submerge the implant and leave it for longer healing period
b- progressive loading with provisional crown to enhance bone density
c- remove the implant since there is mobility
d- proceed with healing abutment installation and check implant stability after soft tissue
healing
96- An upper left central incisor is placed too labially, and the patient presents with labial
gingival recession, labial bone loss, and implant thread exposure. The best management
approach is:
a- flap raised, implant surface disinfection and scaling should be done, connective tissue
grafting to cover the exposed implant
b- flap raised, implant surface disinfection and scaling should be done, autogenous bone
grafting with GBR procedure
c- implant should be submerged, fixed prosthesis fabricated and bonded to the adjacent
teeth
d- implant removed, socket bone grafting with GBR procedure, with soft tissue grafting,
late implant placed after bone grafting healing and maturation
97- In a case of a congenital missing upper lateral incisor with limited mesiodistal
space, the best implant design is:
a- external hex implant
b- one piece implant
c- tapered implant
d- tissue level implant
e- zirconia implant
98- In a case of a GBR procedure with nonresorbable membrane, there is wound

dehiscence and membrane exposure during the healing period. The best management
approach is:
a- soft tissue grafting to close the dehiscence
b- antibiotic, home care with mouth wash and membrane irrigation with chlorhexiden
c- remove the membrane
d- keep under observation until secondary intention healing achieved
Surgical 117
99- For immediate implant placement after tooth extraction in the upper anterior area,
there will be gap distance or jumping distance between the implant surface and the labial wall
of the socket. This distance should be filled by what type of bone graft:
a- autogenous bone graft
b- deminerlised friezed dried bone (allograft)
c- friezed dried bone (allograft)
d- alloplast bone substitutes
100- To ensure a successful GBR procedure, four principles need to be meet:

a- exclusion of epithelium and connective tissue, osteoinduction stimulation, stability of
the fibrin clot, infection free augmented site
b- exclusion of epithelium and connective tissue, space maintenance, stability of the
fibrin clot, and primary wound closure
c- exclusion of epithelium and connective tissue, membrane fixation, no over grafting,
and primary wound closure
d- exclusion of epithelium and connective tissue, space maintenance, partial thickness
flap use, double layer collagen membrane
101- A composite graft may be used for socket preservation after tooth extraction that
comprises:
a- cancellous and cortical bone and gingival tissue harvested in one piece
b- Corticotrabecular block grafts
c- autogenous with bovine bone
d- socket bone grafting with connective tissue coverage
102- Cancellous bone has more osteogenic potential than does cortical bone due to
presence of hematopoietic marrow. However, cortical bone has some advantages over the
cancellous bone, including:
a- provides the most bone morphogenetic protein (BMP)
b- contain high percentage of endothelial growth factor
c- rich in blood vessels that carry osteoprogenerator cells
d- impedes soft tissue ingrowth into the graft site
e- a&d
103- Xenograft/alloplast graft material is typically:

a- osteoconductive
b- osteoinductive
c- osteogenesis
d- angiogenesis
104- The optimal extra- oral donor site that provides the greatest amount of bone is:
a- anterior iliac crest
b- tibial plateau
c- calivarium
d- sternum
105- When an iliac bone graft is placed near the teeth roots, the following complication
will occur:
a- bone graft resorption
b- root resorption
c- root ankyloses
d- soft tissue formation between the graft and the root surface
e- b&c
106- The disadvantages of xenografts include all of the following except:

a- increased risk of a host- immune response
b- high vertical and horizontal bone resorption when used as socket preservation
c- brittleness and easy migration
d- low resorption rate
e- need to mix to autogenous bone to regenerate bone
107- The barrier membrane in a GBR procedure should satisfy the following conditions
except:
a- tissue adhesion without mobility
b- block soft tissue ingrowth
c- resorbable
d- maintains a space
e- biocompatibility
108- The advantage of d- PTFE over e- PTFE is:

a- fast resorption
b- more applicable
c- big pore size
d- bacteria is excluded
e- a&c
109- The collagen membrane usually develops from:

a- type I collagen
b- type II collagen
c- combination of type I and III collagen
d- type IV collagen
e- a&c
Surgical 119
110- Resorbable collagen membrane is degraded by:

a- via hydrolysis
b- the enzymatic activities of macrophages and polymorphonuclear leukocytes
c- tissue fluid
d- immune response Ag
111- The disadvantages of resorbable membranes include all of the following except:
a- fast resorption when exposed to the oral cavity
b- lack space- making ability
c- polymer membrane creates an acid environment during degradation which can have a
negative effect on bone formation
d- cross- linking membrane enhance sever inflammation
e- some types with faster degradation before healing
112- The cortical bone surface is usually perforated with a small, round bur prior to
placing a bone graft. This procedure is called bone marrow penetration or rapid acceleratory
phenomenon. The benefit of this procedure is:
a- to enhance the healing process by promoting bleeding and blood clot formation
b- to allow progenitor cells to reach the bone graft site
c- facilitate angiogenesis in the grafted site
d- to improve the physical interlocking of grafted bone and a recipient site
e- all of the above
113- Marrow penetration, or rapid acceleratory phenomenon, has some adverse effects,
including:
a- additional blood loss
b- sever postoperative pain
c- increased bone loss
d- increased operative time
e- all of the above
114- Regarding the effect of different sizes of cortical perforation (rapid acceleratory
phenomenon), better results and more bone formation can be achieved by:
a- 3 x 15 mm
b- 1 x 10 mm
c- 1.5 x 8 mm
d- 1.5 x 12 mm
e- 2 x 10 mm
115- Esthetic outcomes are more challenging when:

a- only central incisor tooth is missing
b- lateral and canine teeth are missing
c- two central incisors teeth are missing
d- central and incisor teeth are missing
116- To achieve a more predictable outcome in the esthetic zone, the following should be
considered in the treatment plan:
a- smile line
b- Biotype of the periodontium and tooth shape
c- The bony anatomy of the implant site
d- hard and soft tissue amount
e- all of the above
117- In a case of upper posterior missing teeth, only 7 mm of bone height remains under
the maxillary sinus, and the patient declines a sinus lift operation. The alternative treatment
plan is:
a- short and wide implant
b- crestal sinus left approach
c- mini implant
d- angulated implant
e- a&d
118- In a case of a hopeless tooth positioned ideally or apically, to position the gingival at
the required level, the following should be performed:
a- connective tissue grafting
b- orthodontic extrusion
c- socket preservation
d- immediate implantation
119- The thick, flat, periodontal biotype is characterized by all of the following except:
a- denser fibrotic soft tissue
b- tissue reacts to insults by pocket formation
c- the tooth associate with has contact areas located more toward the middle third of the
tooth
d- ample bone located between adjacent roots teeth
e- square anatomic crowns
120- During the treatment of an implant in the esthetic zone, a diagnostic wax- up is
crucial to highlight:
a- final tooth position
b- hard and soft tissue deficiencies
c- the amount of tissue augmentation required
d- type of the prosthesis needed
e- all of the above
Surgical 121
121- The future height of interdental papillae in the esthetic zone of a single missing
tooth is affected by:
a- interproximal bone height of the adjacent teeth
b-periodontal biotype
c-flap design
d-provisional crown
e- all of the above
122- Placing an implant too deep in the esthetic zone will result in the following
complications:
a- poor primary implant stability
b- proximal and facial bone resorption with gingival recession
c- abutment screw loosening
d- bone formation above the implant shoulder
e- c&d
123- Bone saucerization is routinely found around the implant shoulder. The proximal
bone saucerization measures ___________ from the implant surface:
a- 1- 1.5 mm
b- 2- 2.5mm
c- 3- 3.5
d- 1- 3mm
124- The crestal approach for a maxillary sinus lift is selected rather than the lateral
window approach when the residual bone height is:
a- 4- 6mm
b- 3- 5mm
c- 7–9mm
d- 10- 12mm
125- The lateral maxillary sinus lift approach, which involves bone grafting material and
delayed implant placement, is recommended when the residual bone height is:
a- 3- 6mm
b- 5- 7mm
c- 7- 9mm
d- 1–3mm
126- In a case with four missing upper incisors, for better esthetic outcome, the implants
should be placed in the position of:
a- two implant placed in the position lateral incisors, and bridge will connect between 2
implants
b- three implant placed in the position of 2 lateral incisor and one on the position of
central incisor, and bridge will connect 3 implants
c- two implants placed in the position of 2 central incisor, and bridge will connect
between 2 implants and 2 lateral incisor would be cantilever crowns
d- four implant placed in the position of 2 central and 2 lateral incisors, and bridge will
connect 4 implants
e- four implant placed in the position of 2 central and 2 lateral incisors, and single crown
issued for each implant
127- The healing period in maxillary sinus augmentation depends on:

a- antrum width
b- amount of bone graft
c- type of bone graft
d- primary implant stability
e- all of the above
128- Ovalization of the osteotomy site occurs because:

a- Expansion- osteotomes used in soft bone
b- using drills in soft bone
c- change implant angulation during osteotomy
d- thin buccal plate left after osteotomy
129- The most common drawback of an intrasulcular incision is:

a- delay healing
b- prolong gingival inflammation
c- prominent scar tissue
d- keratinized tissue loss
130- The disadvantage of using a submarginal incision in the esthetic zone is:
a- recession of the marginal gingiva
b- wound dehiscence
d- sever oedema
e- all of the above
131- Intrasulcular incisions should be avoided in all of the following cases except:
a- limited alveolar bone width
b- crown and bridge area
c- thin gingival biotype
d- gingival recession area
e- aesthetic zone
Surgical 123
132- The surgical factor that might affect the gingival marginal recession is:
a- flap dehydration during surgery
b- forces to the marginal tissues during flap elevation
c- application of the haemostatic agents
d- flap tension during closure
e- all of the above
133- The resorption rate of allograft bone particles depends on:

a- particle size
b- shape of the particles
c- particle porosity
d- mineralization of the bone graft
e- all of the above
134- The best medium to preserve an autogenous bone graft block during surgery is:
a- glucose water
b- distal water
c- formaldehyde
d- normal saline
135- The healing period for bone graft augmentation is affected by:
a- type of bone graft
b- the size of bone augmentation
c- the site of bone augmentation
d- soft tissue healing and wound closure
e- all of the above
136- The limitation of preoperative ridge mapping is:

a- overestimate the bone width in thick mucosa site
b- underestimation of bone width when the area is totally cancellous bone
c- not enable accurate determination of bone levels in the anterior maxilla (irregular bone
resorption/remodelling in this region)
d- not single assessment method, still need for radiograph
e- all of the above
137- When a rectangular or trapezoidal flap is raised, flap perfusion is maintained until
the ratio of length to width of the parallel pedicle flap equals:
a- 1:1
b- 2:1
c- 1:2
d- 1:3
138- A submarginal flap should only be used when:

a- thin gingival biotype
b- thick gingival biotype
c- narrow zone of attached gingiva
d- there is a broad zone of attached gingiva
e- b&c
139- The recommended thickness of free gingival grafts is:

a- 0.5- 1mm
b- 1- 2 mm
c- 2- 3mm
d- 3- 4mm
140- Points to consider in the design of a soft tissue flap for intraoral surgery include all
of the following except:
a- anatomy
b- access
c- type of tissue
d- closure
e- blood supply
141- To close a three- sided flap with a crestal incision, the first sutures should be:
a- proximal- crestal sutures
b- distal side of vertical incision sutures
c- mesial side of vertical incision sutures
d- mid of the crestal incision sutures
142- For a fully edentulous arch that needs multiple implants, which implant should be
placed first:
a- midline implant
b- first and second from midline
c- most distal implants
d- mesial and distal to the midline
143- The only structure that can be clearly identified in a radiograph and clinically and
can be used as a reference during surgery is:
a- gingival margin
b- implant threads
c- top of the alveolar crest
d- cemento- enamel junction
Surgical 125
144- Tension- free flap closure can be confirmed when:

a- the suture knot does not cause any tissue bleaching
b- the flap edge can be pulled beyond the incision line by 5 mm
c- the wound edge can be approximate edge to edge
d- no wound dehiscence at the time of flap closure
e- c&d
145- From a surgical point of view, lower second molar implant placement is difficult
because of all of the following except:
a- limited access
b- inferior alveolar canal is near the alveolar crest at this area
c- less dense bone
d- narrow occlusal table crown
e- high stress during occlusion
146- Horizontal relieving incisions should be made prior to onlay bone grafting or when
flap tension is identified. What should be considered during a relieving incision procedure:
a- use new scalpel
b- incision should be at the base of the flap
c- depth of the incision should be more than 1mm
d- the incision should be along the flap width
e- all of the above
147- For partial edentulous treatment requiring multiple implants, which implant should
be placed first:
a- most distal
b- middle
c- the longer implant can be placed
d- closest to the tooth
148- Implants should never be placed in the midline of the maxilla because:
a- fracture of the nasal spine
b- expand the suture between two maxilla
c- aesthetic and phonetic complication
d- sever angulation of the implant
e- b&c
149- For a partially edentulous posterior mandibular that needs multiple implants, the
mesiodistal angulation of the implant adjacent to the tooth should be:
a- parallel with the long axis of the root of adjacent tooth
b- parallel with the long axis of the crown of adjacent tooth
c- parallel with the long axis of the most distal implant
d- mesially angulation with the long axis of the of adjacent implant
e- distally angulated with the long axis of the root of adjacent tooth
150- In a complete and severe resorbed edentulous maxilla with pneumatization, the
implant most distal to the canine should be placed in:
a- parallel with most anterior implant and away from the maxillary sinus
b- mesially angulated and parallel to mesial wall of the maxillary sinus
c- distally angulated and should engage the canine fossa
d- distally angulated and follow the mesial wall of the maxillary sinus
151- Vertical ridge augmentation is an unpredictable procedure because:

a- limited amount of bone growing in vertical direction with long healing period
b- difficulty in the soft tissue closure of the augmented site
c- special skill and material needed to create the vertical space
d- autogenous bone is needed in this procedure, means second surgical site
e- all of the above
152- Regarding osteocondensation, all of the following are true except:

a- performed with osteotomes
b- more preferable in type II and type III bone quality
c- enhance primary implant stability
d- minimal removal of bone
e- increase the density of cancellous bone
153- Alveolar splitting and a ridge expansion osteotomy are very beneficial procedures in
a narrow anterior maxillary ridge. The minimum alveolar width for alveolar splitting is:
a- 5mm
b- 1mm
c- 6mm
d- 1.5mm
154- Alveolar splitting and a ridge expansion osteotomy have delayed complications,
including:
a- buccal plate fracture
b- relapse of the buccal plate to the original position and implant threads exposure
c- crestal bone resorption
d- poor implant stability
e- a&c
155- A medically compromised patient with a severely resorbed lower ridge should be
treated with:
a- disk implant
b- lateral and vertical bone augmentation
c- subperiosteal blade implant
d- osteodistraction
e- a&c
Surgical 127
156- A medically compromised patient with a severely resorbed upper ridge should be
treated with:
a- maxillary sinus left augmentation
b- disk implant
c- lateral and vertical bone augmentation
d- zygomatic implant
e- b&d
157- If the alveolar bone width could be precisely determined prior to surgery, the
following would be possible:
a- less invasive flapless surgery
b- determine the amount of bone augmentation needed
c- chose proper implant diameter
d- predict type and position of the future prosthesis
e- all of the above
158- During implant osteotomy preparation, the best irrigation solution is:
a- normal saline
b- glucose water
c- distal water
d- glucose saline
159- The anatomical landmark that should be considered during implant placement in the
inter- mental foramen region for a fully edentulous denture patient is:a- facial artery
b- lingual artery
c- mental nerve
d- anterior loop of the inferior dental nerve
e- all of the above
160- Bone volume loss would be faster after tooth extraction in:
a- posterior of the mandible
b- posterior of the maxilla
c- anterior mandible
d- anterior of the maxilla
161- Sufficient bone height is always available for implant placement at the site of:
a- upper canine area
b- upper incisor area
c- lower anterior area
d- lower first molar area
e- a&c
162- The most predictable area that can regenerate vertical bone is in the:
a- anterior maxilla
b- posterior mandible
c- anterior mandible
d- maxillary sinus
163- For implant placement for a fully edentulous lower denture, the indications for
selecting a flapless procedure rather than a full- thickness flap include all of the following
except:
a- rounded and smooth alveolar ridge
b- Immediate loading
c- Insufficient crown height space
d- medical compromised patient
e- sufficient keratinized mucosa
164- Nerve damage during implant placement can be caused by:

a- complicated anatomic nerve path
b- poor planning design and/or surgical skill
c- decision make on 2D scan
d- the lack of using computer guided surgical guide
e- all of the above
165- Different surgical techniques can be utilized to increase the width of the keratinized
soft tissue around an implant. All of the following are true about these procedures except:
a- periosteum release and coronal repositioning flap
b- apical repositioning flap
c- lingualized incision designs
d- pedicle grafts
e- connective tissue graft
166- A patient with a high- vault palate is preferred as donor for connective tissue
harvesting because:
a- away form the incisive foramen
b- less adipose tissue
c- harvesting a good amount of tissue
d- reduces the risk of endangering the greater palatine artery
e- c&d
167- Free gingival grafts have been proven to be successful. However, these also have
disadvantages, including all of the following except:a- two surgical sites with more morbidity
b- discrepancies in color with the surrounding mucosa
c- percentage of shrinkage should be expected
d- need at least 1mm of keratinized mucosa around implant
e- discrepancies in texture with the surrounding mucosa
Surgical 129
168- A combination flap for alveolar splitting or a ridge expansion osteotomy in a narrow
maxillary ridge should consist of:
a- split- thickness flap at the crest of the ridge, then transitioned into full- thickness along
the buccal plate
b- full- thickness flap at the crest of the ridge, and periosteal scoring on the base of the
flap
c- full- thickness flap at the crest of the ridge, then transitioned into a split- thickness flap
along the buccal plate
d- vestibular full- thickness flap raised with double flap closure
vestibular full- thickness flap with connective tissue graft
169- The advantages of a combination flap for alveolar splitting or a ridge expansion
osteotomy in a narrow maxillary ridge include all of the following except:
a- better surgical filed vision
b- prevent the buccal bone from collapse during healing period
c- better determining the positioning of the ridge splitting
d- protecting the buccal plate from full fractures during the expansion
e- preserve the blood supply to the buccal plate
170- When a bone block graft needs to harvest from a symphysis area, the following
distances are needed to avoid endangering the adjacent vital structures:
a- superior osteotomy made 5 mm below the root apices and the inferior osteotomy at
least 5 mm above the inferior border, lateral osteotomy 5mm from the inferior dental
nerve
b- superior osteotomy made 8 mm below the root apices and the inferior osteotomy at
least 7mm above the inferior border, lateral osteotomy 5mm from the mental foramen
c- superior osteotomy made 5 mm below the root apices and the inferior osteotomy at
least 3 mm above the mentalis muscle, lateral osteotomy 7mm from the mental
foramen
d- superior osteotomy made 3 mm below the root apices and the inferior osteotomy at
least 7mm above the inferior border, lateral osteotomy 5mm from the mental foramen
171- A frequent postoperative complaint when harvesting symphyseal grafts is:

a- Sensory alterations to mandibular incisors
b- wound dehiscence and food accumulation
c- lower lip numbness
d- shallowing of the labial vestibular depth
e- all of the above
172- Following symphysis bone harvesting, the patient may be concerned about a
deformity of the chin contour. To avoid ptosis, the following should be performed:
a- avoid complete degloving of the chin
b- always use subcrivecular incision flap
c- no more than 1 cm bone block width, height and length should be harvested
d- periosteum scoring before flap closure to prevent tension flap closure
e- all of the above
173- To achieve a better esthetic result for an implant placed in the esthetic zone with a
thin gingival biotype, the implant should be placed:
a- labial and apical
b- palatal and coronal
c- labial and coronal
d- palatal and apical
174- Blood supply is an important factor in the success of a bone grafting procedure. The
posterior resorbed ridge of the mandible always suffers from a diminished blood supply
during bone augmentation because:
a- higher cortical bone content in this area
b- difficult to achieve tension- free primary flap closure
c- less keratinized tissue always found
d- central blood supply
e- a&b
175- a single- stage bone augmentation protocol is preferred for small- volume hard
tissue defects around implant if the following is achieved:
a- adequate keratinized tissue
b- flap closure without tension
c- adequate primary implant stability
d- autogenous bone graft used
e- all of the above
176- Advantages of a single- stage bone augmentation protocol include all of the
following except:
a- minimizes compression and migration of particulate graft material
b- allows the bony and soft tissue to develop around the healing abutment
c- reduce surgeries
d- give the chance of clinical recheck of bone formation
e- decrease the incidence of labial vestibule shallowing
Surgical 131
177- The tunneling technique is feasible for lateral bone augmentation, but this procedure
has drawbacks, including:
a- wound dehiscence
b- difficult to position the graft coronally
c- apical migration of graft material during healing
d- difficult to separate the periosteum during flap dissection
e- b&c
178- A common biological complication reported for zygomatic implants is:

a- sinusitis
b- soft tissue infections
c- paraesthesia
d- oroantral fistula
e- all of the above
179- The advantage of the extramaxillary surgical technique for zygomatic implants
compared to the classical technique is:
a- minimized the rate of ruptures of the sinus membrane during implant insertion
b- use longer implant
c- the implant is fully embedded in the maxilla and zygomatic bone
d- implant head is more vestibular
e- a&d
180- To reduce the angle of deviation during an osteotomy, the surgical stent should
have:
a- narrow guide channel
b- long guide channel
c- wide guide channel
d- labial open guide channel
e- a&d
181- Finger rest during drilling or socket preparation should be avoided because this will
cause inclination of the drill and a mal- angled implant placement:
a- both statement is wrong
b- first statement is correct but the second statement is wrong
c- first statement is wrong but the second statement is correct
d- both statement is correct
182- Possible factors related to Schneiderian membrane tearing during the lateral
approach technique include:
a- absence of alveolar bone
b- overfilling with the graft material with insufficient elevation of the membrane
c- previous sinus surgery
d- irregularities of the sinus floor
e- all of the above
183- In a flapless punch procedure, a soft tissue punch should be used for better peri-
implant mucosa adaptation and subsequent healing:
a- diameter bigger than that of the implant
b- remove only mucosa and leave the periosteum intact
c- smaller than that of the implant
d- rotary and not manual
e- b&d
184- The iliac crest is frequently used as a bone graft donor site for major jaw
reconstruction procedures. All of the following are true about this procedure except:
a- there is a significant resorption of the bone graft
b- iliac bone has same histological origin of jaw bone (membranous)
c- altered ambulation
d- need for hospitalization
e- large volume of bone graft can be obtained
185- Immediate implant placement and provisionalization is usually the preferred method
if ideal pre- existing tissue conditions exist. All of the following are true except:
a- scalloped gingiva
b- presence of adequate buccal bone plate
c- thick biotype
d- appropriate gingival level
e- favourable osseous- gingival relationship
186- The advantages of the horizontal mattress suture technique include all of the
following except:
a- precise flap placement with periosteal stabilization
b- avoiding suture contact with the implant material
c- resist muscle pull
d- adapt the surgical flaps to the underlying bone
e- evert the surgical flap edges
187- A 1/2- circle suture needle is used more frequently in:

a- areas of restricted space
b- suturing a soft tissue graft
c- vertical bone augmentation flap closure
d- retromolar donor flap site closure
e- a&b
188- A crestal incision is more favorable under all of the following conditions except:
a- mandible has sufficient height
b- muscle insert below the alveolar crest (mentalis and lip musculature)
c- adequate band of attached gingiva
d- knife edge ridge
e- rounded edge ridge
Surgical 133
189- The advantages of a crestal incision include all of the following except:
a- provides excellent access to both the labial and the lingual regions
b- do not interfere with the blood supply to the flap
c- closure away from the implant material
d- preserves the vestibular depth and keratinized tissue
e- reduces the postsurgical sequelae
190- Vestibular incisions drawbacks include all of the following except:

a- more edema and patient discomfort
b- suture placement and removal are more difficult
c- dehiscence will result in implant exposure
d- flange of any transitional prosthesis will impinge on the incision line
e- vital structure damage
191- In an edentulous ridge, lingual and facial flap capillaries do not anastomose at the
ridge crest. Crestal incisions could result in a loss of vascularity to the tissues of the elevated
flaps.:
a- both statement is incorrect
b- first statement in is incorrect, while second statement in correct
c- both statement is correct
d- first statement is correct, while second statement in incorrect
192- In a lower posterior edentulous area, an implant placed with thin mucosa has less
crestal bone resorption. Implants with a smooth transmucosal design are not favored in a thin
mucosa area:
a- both statement is correct
c- first statement is correct, while second statement in incorrect
d- both statement is incorrect
193- A passive and tension- free flap closure is important and can be achieved through:
a- para- crestal incision with three sided flap
b- scoring of the periosteum
c- elevating a split thickness flap apically
d- vertical mattress suture
e- b&c
194- Evaluating gingival thickness before implant placement is crucial because it affects
the selection of:
a- implant design
b- flap design
c- abutment design
d- abutment material
e- all of the above
195- Causes of flap trauma during reflection include all of the following except:
a- incomplete cutting (periosteum) full thickness flap
b- thin gingival tissue raised
c- rounded alveolar ridge
d- blunt non sharp instrument used to reflect the flap
e- presence of fibrous tissue tags
196- the drawback of the crestal approach for maxillary sinus augmentation with the
alveolar bone core technique is:
a- less support to the elevated membrane by the core
b- difficult to solve the sinus membrane perforation
c- less autogenous bone displacement in the elevated sinus
d- bone core maybe removed with the trephine bur
e- all of the above
197- Muscle cutting during periosteum scoring can lead to all of the following except:
a- ecchymosis postoperatively
b- increase flap tension
c- intraoperative bleeding
d- muscle activity interruption
e- postoperative oedema
198- Chlorhexidine mouthwash is not preferred after surgery because:

a- fibrocyte toxicity
b- increase bacterial resistance
c- limited bactericidal effect
d- cause suture flake
e- b&c
199- The flap design for a lateral approach sinus lift in a fully edentulous atrophied ridge
should consider all of the following except:
a- incision more palatal
b- palatine artery pathway
c- incisive nerve
d- inferior orbital nerve and vessels
e- pneumatisation extension and window position
200- To avoid scar formation in the esthetic zone, the incision technique should consider
all of the following except:
a- no vertical incision in the keratinized gingiva
b- no vertical incision on the mucosa
c- use fine suture and needle
d- avoid secondary healing
e- avoid incision on the concave surface or root prominence
Surgical 135
201- Distraction osteogenesis has some disadvantages and limitations, including all of the
following except:
a- epithelialization may occurs along the device
b- need second surgery to remove the device
c- limited in the horizontal movement
d- doesn’t give increase in the soft tissue volume
e- limited by the need for space above or below the moving segment
202- Distraction osteogenesis is activated at a rate of:

a- 1 mm per day (once daily)
b- 0.5 mm per day (once daily)
c- 2 mm (alternative day)
d- 1 mm per day (0.5 mm twice daily)
203- During zygomatic implant placement, the raised flap should expose all of the
following anatomical structure except:
a- pterygoid plate
b- infraorbital nerve and foramen
c- anterior portion of the zygomatic arch
d- medial aspect of the zygoma
e- piriform rim
204- Contraindications of zygomatic implant placement include all of the following

except:
a- lateral wall of the maxilla is severely concave
b- maxillary sinus with pathological condition
c- pneumatisation or maxillary sinus expansion
d- less than 8 mm of bone in the zygomatic bone available
e- insufficient anterior bone availability for the placement of anterior implants to stabilize
the restoration
205- For socket preservation with bone grafting, the graft should have all of the following
characteristics except:
a- preserve the space to maintain the bone volume
b- bone graft with small particles for better condensation
c- do not transfer pathologic diseases
d- osteoconductive ability
e- convert into dense bone for better implant stability
206- The thin gingival biotype is unfavorable in the esthetic zone due to gingival
recession and visible metal, the most predictable procedure to change thin gingiva into thick
is:
a- connective tissue graft
b- bone graft
c- apical repositioning flap
d- collagen membrane placement
e- c&d
207- Generally, labial bone defects occur after tooth extraction, but there are cases in
which palatal bone defects occur:
a- in the region of persistence deciduous tooth and missing permanent tooth
b- surgical removal of ankylosed tooth
c- palatal inclined tooth
d- tooth involved with periapical lesion
e- c&d
208- Factors that may affect the flap design for the procedure of a chin donor site include
a- depth of the vestibule
b- amount of keratinized tissue
c- root length of the lower anterior teeth
d- periodontal condition of the lower anterior teeth
e- gingival biotype
209- A medically compromised patient may have poor wound healing, including:
a- uncontrolled diabetes
b- chronic steroid use
c- immunocompromise
d- alcoholism
e- all of the above
210- Contraindications for immediate implant placement may be related to all of the
following except:
a- purulent discharge
c- gingivitis
d- patient history of poor wound healing (medical compromised patient)
e- lack of bone to stabilize an implant
Surgical 137
211- Immediate implant placement in an intact socket wall defect will preserve alveolar
bone resorption, while immediate implant placement in a compromised socket will reduce
alveolar bone resorption:
a- both sentences incorrect
b- first sentence is correct while the second sentence is incorrect
c- first sentence is incorrect while the second sentence is correct
d- both sentences is correct
212- Immediate implant placement is contraindicated for a compromised anatomical

shape of the socket. All of the following are true except:
a- the labial bone is extremely thin and the socket is large
b- thin palatal bone of the socket and high palatal vault
c- implant placement lead to the engagement of the palatal and proximal bone of the
socket
d- proximal bone of the socket is missing and root exposure of the adjacent teeth
e- thin bone available between the root apex and the vital structure (e.g., maxillary sinus,
inferior dental nerve)
213- During immediate implant placement after tooth extraction in the esthetic zone, the
implant should be placed at the level of:
a- 3mm from the cemento- enamel junction of the adjacent teeth
b- 3mm from the gingival margin
c- subcrestal by 1mm
d- supracrestal by 1mm
e- subcrestal by 2mm
CORRECT ANSWERS
Q1
b- significantly reduced, but not completely inhibited
Q2
a- significant socket shrinkage
Q3
d- 3 month, 12 month
Q4
d- decreased progressively towards the apical level
Q5
c- tumor
Q6
a- one week
Q7
b- 2 weeks
Q8
c- 4 weeks
Q9
e- all of the above
Q10
e- none of the above (accumulate plaque, allow rapid bacterial colonization and are
uncomfortable to remove because of ingrowth of tissue)
Q11
d- cost
Q12
b- Teflon
Q13
a- 40%
Q14
e- c&d
Q15
b- destructive former sinus surgery (like the Caldwell–Luc operation)
Q16
a- the last 5 mm of the implant apical region
Q17
Q18
d- all of the above (bleeding due to thrombocytopenia and drug protease inhibitor,[
inection and healing due to the levelo of the CD4 T cells)
Q19
a- finer suture diameters
Q20
e- all of the above
Surgical 139
Q21
a- pulling the tongue outside patient mouth
Q22
c- increase implant stability
Q23
b- bone formation from bone edge and covering the implant apex
Q24
b- the apex of the drill (1.5) not estimated in most implant system
Q25
c- make second hole adjacent to the primary hole drilling within 1- 2mm
Q26
d- obscure the adjacent anatomical teeth structures
Q27
e- a&c
Q28
a- palatally placed but labially angulated
Q29
e- c&d
Q30
c- 3- 4 weeks
Q31
b- 8 mm
Q32
b- collagen membrane barrier place underneath the membrane
Q33
a- membrane elevation
Q34 c- bone height underneath the maxillary sinus is <5
Q35
e- all of the above
Q36
d- immediate implant placement with immediate crowning
Q37
e- none of the above (no treatment needed, subsided by itself, advise the patient to
maintain good oral hygiene)
Q38
c- full exposure of the cover screw and healing abutment placed
Q39
Q40
e- none of the above (15c with small head that can go between the teeth and interdental
papillae
Q41
a- result of the rapid accelerating phenomena (RAP)
Q42
e- b&c
Q43
d- blockage of the irrigation holes with debris
Q44
e- all of the above
Q45
b- infection and contamination through the root surface
Q46
e- all of the above
Q47
c- difficult to control implant placement angulation due to uncontrolled force
Q48
e- all of the above
Q49
a- resonance frequency analysis
Q50
c- smooth surfaces will exert shear forces to the bone that enhance crestal bone resorption
Q51
e- all of the above
Surgical 141
Q52
d- nerve lateralisation
Q53
b- anatomical factor
Q54
c- collapse of the labial wall of the socket in towards the implant surface
Q55
e- a&b
Q56
e- b&c
Q57
b- between the cingulum and the incisal edge
Q58
c- 0.6mm
Q59
e- none of the above (to get more primary implant stability)
Q60
a- antibiotic prescription, maintain good oral hygiene, special care to the exposed
membrane by chlorhexiden irrigation and removal of the plaque from the membrane
Q61
b- vertical mattress with simple interrupted suture in between
Q62
e- all of the above
Q63
e- c&d
Q64
e- all of the above
Q65
e- a&d
Q66
b- soft tissue formation on the surface of the implant from the foramen
Q67
e- b&c
Q68
e- all of the above
Q69
d- need hospital admitting
Q70
c- not advocated in medically compromised patient
Q71
a- hyperaesthesia
Q72
c- axontemesis
Q73
a- 6- 8weeks
Q74
e- a&b
Q75
b- 10 Ncm
Q76
e- all of the above
Q77
e- c&d
Q78
b- papillae preservative incision
Q79
e- all of the above
Q80
a- indicated when limited keratinized tissue found
Q81
d- more preferred in the aesthetic area
Surgical 143
Q82
e- all of the above
Q83
c- graft mobility prevent blood vessels sprouting into the graft material
Q84
a- blood vessels originated from the bone carrying the osteoblast progenitor cells
Q85
b- under the buccal cusp
Q86
d- cause diminish blood supply to the surrounding bone
Q87
c- minimal invasive with blood supply preservation
Q88
e- a&d
Q89
a- early attachment of the blood clot
Q90
d- sinus septae
Q91
b- pneumatisation
Q92
e- c&d
Q93
e- all of the above
Q94
c- trephine bure used to remove the implant, followed by bone grafting with GBR
procedure, late implant placement after bone grafting healing
Q95
a- submerge the implant and leave it for longer healing period
Q96
d- implant removed, socket bone grafting with GBR procedure, with soft tissue grafting,
late implant placed after bone grafting healing and maturation
Q97
b- one piece implant
Q98
c- remove the membrane
Q99
e- none of the above (slowly resorbed bone substitutes, xenograft)
Q100
b- exclusion of epithelium and connective tissue, space maintenance, stability of the
fibrin clot, and primary wound closure
Q101
a- cancellous and cortical bone and gingival tissue harvested in one piece
Q102
e- a&d
Q103
a- osteoconductive
Q104
e- none of the above (posterior iliac crest)
Q105
e- b&c
Q106
b- high vertical and horizontal bone resorption when used as socket preservation
Q107
c- resorbable
Q108
d- bacteria is excluded
Q109
e- a&c
Q110
b- the enzymatic activities of macrophages and polymorphonuclear leukocytes
Q111
a- fast resorption when exposed to the oral cavity
Surgical 145
Q112
e- all of the above
Q113
e- all of the above
Q114
a- 3 x 15 mm
Q115
c- two central incisors teeth are missing
Q116
e- all of the above
Q117
e- a&d
Q118
b- orthodontic extrusion
Q119
d- ample bone located between adjacent roots teeth
Q120
e- all of the above
Q121
e- all of the above
Q122
b- proximal and facial bone resorption with gingival recession
Q123
a- 1- 1.5mm
Q124
c- 7–9mm
Q125
d- 1- 3mm
Q126
a- two implant placed in the position lateral incisors, and bridge will connect between 2
implants
Q127
e- all of the above
Q128
b- using drills in soft bone
Q129
e- none of the above (gingival margin recession)
Q130
Q131
a- limited alveolar bone width
Q132
e- all of the above
Q133
e- all of the above
Q134
d- normal saline
Q135
e- all of the above
Q136
e- all of the above
Q137
b- 2:1
Q138
d- there is a broad zone of attached gingiva
Q139
b- 1- 2mm
Q140
c- type of tissue
Q141
a- proximal- crestal sutures
Surgical 147
Q142
c- most distal implants
Q143
c- top of the alveolar crest
Q144
b- the flap edge can be pulled beyond the incision line by 5 mm
Q145
d- narrow occlusal table crown
Q146
e- all of the above
Q147
d- closest to the tooth
Q148
e- b&c
Q149
a- parallel with the long axis of the root of adjacent tooth
Q150
d- distally angulated and follow the mesial wall of the maxillary sinus
Q151
e- all of the above
Q152
b- more preferable in type II and type III bone quality
Q153
e- none of the above (3mm)
Q154
b- relapse of the buccal plate to the original position and implant threads exposure
Q155
e- a&c
Q156
e- b&d
Q157
e- all of the above
Q158
a- normal saline
Q159
e- all of the above
Q160
b- posterior of the maxilla
Q161
e- a&c
Q162
d- maxillary sinus
Q163
c- Insufficient crown height space
Q164
e- all of the above
Q165
a- periosteum release and coronal repositioning flap
Q166
e- c&d
Q167
d- need at least 1mm of keratinized mucosa around implant
Q168
c- full- thickness flap at the crest of the ridge, then transitioned into a split- thickness flap
along the buccal plate
Q169
b- prevent buccal plate bone resorption during healing period
Q170
e- none of the above (superior osteotomy made 5 mm below the root apices and the
inferior osteotomy at least 5 mm above the inferior border, lateral osteotomy 5mm from the
mental foramen)
Surgical 149
Q171
a- Sensory alterations to mandibular incisors
Q172
a- avoid complete degloving of the chin
Q173
d- palatal and apical
Q174
e- a&b
Q175
c- adequate primary implant stability
Q176
d- give the chance of clinical recheck of bone formation
Q177
e- b&c
Q178
e- all of the above
Q179
e- a&d
Q180
b- long guide channel
Q181
d- both statement is correct
Q182
e- all of the above
Q183
c- smaller than that of the implant
Q184
b- iliac bone has same histological origin of jaw bone (membranous)
Q185
a- scalloped gingiva
Q186
b- avoiding suture contact with the implant material
Q187
e- a&b
Q188
d- knife edge ridge
Q189
c- closure away from the implant material
Q190
c- dehiscence will result in implant exposure
Q191
d- first statement is correct, while second statement in incorrect
Q192
Q193
e- b&c
Q194
e- all of the above
Q195
c- rounded alveolar ridge
Q196
d- bone core maybe removed with the trephine bur
Q197
b- increase flap tension
Q198
a- fibrocyte toxicity
Q199
c- incisive nerve
Q200
b- no vertical incision on the mucosa
Surgical 151
Q201
d- doesn’t give increase in the soft tissue volume
Q202
d- 1 mm per day (0.5 mm twice daily)
Q203
a- pterygoid plate
Q204
c- pneumatisation or maxillary sinus expansion
Q205
b- bone graft with small particles for better condensation
Q206
a- connective tissue graft
Q207
a- in the region of persistence deciduous tooth and missing permanent tooth
Q208
c- root length of the lower anterior teeth
Q209
e- all of the above
Q210
Q211
a- both sentences incorrect
Q212
c- implant placement lead to the engagement of the palatal and proximal bone of the
socket
Q213
b- 3mm from the gingival margin
REFERENCES
Ab Rahmanm S, Al- Juboori MJ, Bin Ismail IH, Chandar PM. Dental implant stability from
placement to loading. Dent Implantol Update. 2012;23:61–4.
Al-Juboori MJ, bin Abdulrahaman S, Dawood HF, principles of flap designe in dental
implantology. Dent Implantol Update 2012;23:41–4.
Al-Juboori MJ, bin Abdulrahaman S, Subramaniam R, Tawfiq OF Less morbidity with
flapless implant. Dent Implantol Update. 2012;23:25–30.
Alberius P, Gordh M, Lindberg L, et al. Effect of cortical perforations of both graft and host
bed on onlay incorporation to the rat skull. Eur J Oral Sci 1996;104:554–61.
Albrektsson T, Sennerby L Direct bone anchorage of oral implants: Clinical and experimental
consideration of the concept of osseointegration. Int J Prosthodont 1990;3:30–41.
Al-Juboori MJ, bin Abdulrahaman S, Causes of Crestal Bone Resorption in the Dental
Implant Patient. Dent Implantol Update, 2012;23:49–56.
Al-Juboori MJ, Bin Ismail IH, Ab Rahman S. Dental implant stability and its measurement.
Dent Implantol Update. 2012;23:57–61.
Al-Juboori MJ, Filho LC The influence of flap design and technique on dental implant
success, prognosis and morbidity: mini review, International Journal of Contemporary
Dental and Medical Review 2015:1–4.
Allen F, Smith DG An assessment of the accuracy of ridge mapping in planning implant
therapy for the anterior maxilla. Clin Oral Impl Res 2000:11:34–38.
Al-Sayyed A, Deporter DA, Pilliar RM, Watson PA, Berhane K, Carter S. Predictable crestal
bone remodelling around two porous-coated titanium alloy dental implant designs. A
radiographic study in dogs. Clin Oral Implants Res 1994;5:131–141.
Ardekian L, Oved-Peleg E, Mactei EE, et al. The clinical significance of sinus membrane
perforation during augmentation of the maxillary sinus. J Oral Maxillofac Surg
2006;64:277–282.
Barboza E, Caula A, Machado F. Potential of recombinant human bone morphogenetic
protein-2 in bone regeneration. Implant Dent 1999;8:360–7.
Bartee BK, Carr JA. Evaluation of a high-density polytetrafluoroethylene (n-PTFE)
membrane as a barrier material to facilitate guided bone regeneration in the rat mandible.
J Oral Implant 1995; 21: 88–95.
Bayounis AM, Alzoman HA, Jansen JA, Babay N. Healing of peri-implant tissues after
flapless and flapped implant installation. J Clin Periodontol 2011:38:754–761.
Becker W, Goldstein M, Becker BE, Sennerby L. Minimally invasive flapless implant
surgery: a prospective multicenter study. Clin Implant Dent Related Res 2005;7(Suppl.
1): S21–S27.
Binderman I, Adut M, Zohar R, Bahar H, Faibish D, Yaffe A. Alveolar bone resorption
following coronal versus apical approach in a mucoperiosteal flap surgery procedure in
the rat mandible. J Periodontol 2001;72:1348–1353.
Bunyaratavej P, Wang HL. Collagen membranes: a review. J Periodontol 2001;72: 215–29.
Buser D, Bragger U, Lang NP, et al. Regeneration and enlargement of jaw bone using guided
tissue regeneration. Clinl Oral Implants Res 1990;1: 22–32.
Chee W W. Provisional restorations in soft tissue management around dental implants. J
Periodontol 2000 2001;27:139–147. 21.
Chee W W. Treatment planning and soft-tissue management for optimal implant aesthetics: a
prosthodontic perspective. J Calif Dent Assoc 2003;31:559–563.
Choi M, Romberg E, Driscoll CF. Effects of varied dimensions of surgical guides on implant
angulations. J Prosthet Dent 2004;92:463–469.
Surgical 153
Choquet V, Adriaenssens P, Daelemans P et al. Clinical and radiographic evaluation of the

papilla level adjacent to single tooth implants. A retrospective study in the maxillary
anterior region. J Periodontol 2001;2:1364–1371.
Chrcanovic BR, Abreu MH. Survival and complications of zygomatic implants: A systematic
review. Oral Maxillofac Surg 2013;17:81–93.
Cordioli G, Mazzocco C, Schepers E, Brugnolo E, Majzoub Z. Maxillary sinus floor
augmentation using bioactive glass granules and autogenous bone with simultaneous
implant placement. Clinical and histological findings. Clin Oral Implants Res.
2001;12:270–278. 14.
de Araújo Nobre M1, Maló P, Gonçalves I. Evaluation of Clinical Soft Tissue Parameters for
Extramaxillary Zygomatic Implants and Conventional Implants in All- on- 4 Hybrid
Rehabilitations: Short-Term Outcome and Proposal of Clinical Recommendations for
Intervention in Recall Appointments. Implant Dent 2015;24:267–74.
Dragoo MR, Sullivan HC. A clinical and histological evaluation of autogenous iliac bone
grafts in humans. II. External root resorption. J Periodontol 1973; 44: 614–25.
Elkhaweldi A, Rincon Soler C, Cayarga R, Suzuki T, Kaufman Z. Various Techniques to
Increase Keratinized Tissue for Implant Supported Overdentures: Retrospective Case
Series. Int J Dent 2015;:104903.
Fickl S, Kebschull M, Schupbach P, Zuhr O, Schlagenhauf U, Hurzeler MB. Bone loss after
full-thickness and partial-thickness flap elevation. J Clin Periodontol 2011;38:157–162.
Fickl S, Zuhr O, Wachtel H, Bolz W, Huerzeler M. Tissue alterations after tooth extraction
with and without surgical trauma: a volumetric study in the beagle dog. J Clin
Periodontol 2008a;35:356–363.
Fickl S, Zuhr O, Wachtel H, Bolz W, Huerzeler MB. Hard tissue alterations after socket
preservation: an experimental study in the beagle dog. Clin Oral Implants Res
2008b;19:1111–1118.
Fickl S, Zuhr O, Wachtel H, Kebschull M, Huerzeler MB. Hard tissue alterations after socket
preservation with additional buccal overbuilding: a study in the beagle dog. J Clin
Periodontol 2009b;36:898–904.
Fickl S, Zuhr O, Wachtel H, Stappert CF, Stein JM, Hurzeler MB. Dimensional changes of
the alveolar ridge contour after different socket preservation techniques. J Clin
Periodontol 2008c;35:906–913.
Fickl, S, Schneider D, Zuhr O, Hinze M, Ender A, Jung RE, Hurzeler MB. Dimensional
changes of the ridge contour after socket preservation and buccal over-building: an
animal study. J Clin Periodontol 2009a;36:442–448.
Garg AK. Bone Biology, Harvesting, & grafting for dental implants: rationale and clinical
applications, Quintessence, Illinois, 2004.
Gordh M, Alberius P, Lindberg L, Johnell O. bone graft incorporation after cortical
perforations of the host bed. Otolaryngol Head Neck Surg 1997;117: 664–70.
Greenberg JA, Wiltz MJ, Kraut RA Augmentation of the anterior maxilla with intraoral onlay
grafts for implant placement. Implant Dent. 2012;21:21–4.
Grunder U. Crestal width changes when placing implants at the time of tooth extraction with
and without soft tissue augmentation after a healing period of 6 months: report of 24
consecutive cases. Int J Periodon Restorative Den 2011;31:9–17.
Hahn J. Single-stage, immediate loading, and flapless surgery. J Oral Implantol 2000;26:193-
8.
Harrison JW, Jurosky KA Wound healing in the tissues of the periodontium following
periradicular surgery. I. The incisional wound. J Endodontics 1991;17:425–35.
Heller AL, Heller RL, Cook G, D'Orazio R, Rutkowski J. Soft tissue management techniques
for implant dentistry: a clinical guide. J Oral Implantol 2000;26:91–103.
Howe G. Minor Oral Surgery, 3rd ed. Oxford: Butterworth-Heinemann Ltd; 1985:79–81.
Jensen OT, Shulman LB, Block MS, Iacone, VJ. Report of the sinus consensus conference of
1996. Int J Oral Maxillofac Implants 1998;13 (Special sup.):11–32.
2006;201:77–89.
Kan J, Rungcharassaeng K, Umezu K, Kois J C. Dimensions of peri-implant mucosa. An
evaluation of maxillary anterior single implants in humans. J Periodontol 2003;4:557–
562.
Kan JY1, Rungcharassaeng K, Umezu K, Kois JC. Dimensions of peri-implant mucosa: An
evaluation ofmaxillary anterior single implants in humans. J Periodontol 2003;74:557–
562.
Kleinheinz J, Büchter A, Kruse-Lösler B, Weingart, Joos U. Incision design in implant
dentistry based on vascularization of the mucosa. Clin Oral Implants Res 2005;16:518–
523.
Kois J C. Predictable single tooth peri-implant aesthetics: Five diagnostic keys. Compendium
2004;25:895–905.
Kramper BJ, Kaminski EJ, Osetek EM, Heuer MA A comparative study of the wound healing
of three types of flap design used in periapical surgery. J Endodontics 1984;10:17–25.
Lang NP & Lindhe J clinical periodontology an implant dentistry, 5th edition, Blackwell,
2010
Lang NP, Hammerle CH, Bragger U, et al. Guided tissue regeneration in jawbone defects
prior to implant placement. Clin Oral Implants Res 1994;5:92–7.
Lang NP, Loe H. The relationship between the width of keratinized gingiva and gingival
health. J Periodontol 1972;43:623–7.
Le B, Burstein J. Esthetic Grafting for Small Volume Hard and Soft Tissue Contour Defects
for Implant Site Development. Implant Dent 2008;17:136–41.
Leong DJ, Oh TJ, Benavides E, Al-Hezaimi K, Misch CE, Wang HL Comparison between
sandwich bone augmentation and allogenic block graft for vertical ridge augmentation in
the posterior mandible. Implant Dent 2015;24:4–12.
Liu J, Kerns DG. Mechanisms of Guided Bone Regeneration: A Review. Open Dent J
2014;8:56–65.
Lundgren AK, Lundgren D, Hammerle CH, et al. Influence of decortication of the donor bone
on guided bone augmentation: an experimental study in the rabbit skull bone. Clin Oral
Implants Res 2000;11:99–10.
MichaelidesPL, WilsonSG Acomparison of papillary retention versus full-thickness flaps
with internal mattress sutures in anterior periodontal surgery. Int J Periodontics
Restorative Dent 1996;16:388–97.
Micheal s. block. Color Atlas of Dental Implant Surgery, 3rd Edition Saunders; Missouri,
2010.
Miller N, Penaud J, Foliguet B, et al. Resorption rates of 2 commercially available
bioresorbable membranes: a histomorphometric study in a rabbit model. J Clin
Periodontol 1996;23:1051-9.
Surgical 155
Misch CE, Dietsh F. Bone-grafting materials in implant dentistry. Implant Dent 1993;2:158–
67.
Misch K, Wang HL. Implant Surgery Complications: Etiology and Treatment. Implant Dent
2008;17:159–68.
Mörmann W, Ciancio SG. Blood supply of human gingiva following periodontal surgery. A
fluorescein angiographic study. J Periodontol 1977;48: 681–92.
Mörmann W, Schaer F, Firestone AR. Firestone The relationship between success of free
gingival grafts and transplant thickness. Revascularization and shrinkage: a one year
clinical study. J Periodontol 1981;52:74–80.
MörmannW, SchaerF, FirestoneA. Therelationshipbetweensuccess of free gingival grafts and
transplant thickness. Revascularization and shrinkage—one-year clinical study. J
Periodontol 1981;52:74–80.
Neale D, Chee W W. Development of soft tissue emergence profile: A technique. J Prosthet
Dent 1994;71:364–368.
Nedir R, Bischof M, Vazquez L, Szmukler-Moncler S, Bernard J-P. Osteotome sinus floor
elevation without grafting material: a 1-year prospective pilot study with ITI implants.
Clin. Oral Impl Res. 2006;17:679–686.
Nishimura I, Shimizu Y, Ooya K. Effects of cortical bone perforation on experimental guided
bone regeneration. Clin Oral Implants Res 2004;15:293–300.
Owens KW, Yukna RA. Collagen membrane resorption in dogs: a comparative study.
Implant Dent 2001;10:49–58.
Palmer P, Palmer R Implant surgery to overcome anatomical difficulties. Br Dent J
1999;187:532–40.
Palmer R, Palmer P, Floyd P Basic implant surgery. Br Dent J 1999;187:425–20.
Petrie CS, Williams JL. Comparative evaluation of implant designs: influence of diameter,
length, and taper on strains in the alveolar crest. A three-dimensional finite-element
analysis. Clin Oral Impl Res. 2005;16:486–494.
Raghoebar GM, Weissenbruch R, Vissink A. Rhino-sinusitis related to endosseous implants
extending into the nasal cavity. A case report. Int J Oral Maxillofac Surg. 2004;33:312–
314.
Reiser GM, Rabinovitz Z, Bruni J, Damoulis P, Griffin TJ. Evaluation of maxillary sinus
membrane response following elevation with the crestal osteotome technique in human
cadavers. Int J Oral Maxillofac Implants 2001;16: 833–840.
Sadig W, Almas K. Risk Factors and Management of Dehiscent Wounds in Implant
Dentistry. Implant Dent 2004;13:140–7.
Salama H, Salama M, Kelly J. The orthodontic-periodontal connection in implant site
development. Prac Perio Aest Dent 1996;8:923–932.
Schallhorn RG. Postoperative problems associated with iliac transplants. J Periodontol 1972;
43:3–9.
Scherer MD, Ingel AP, Rathi N, Flapped or Flapless Surgery for Narrow-Diameter Implant
Placement for Overdentures: Advantages, Disadvantages, Indications, and Clinical
Rationale. Int J Periodontics Restorative Dent 2014;34(suppl):s89–s95.
Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone healing and soft tissue contour
changes following single- tooth extraction: a clinical and radiographic 12-month
prospective study. Int J Periodontics Restorative Dent 2003;23:313–323.
Selvig KA, Biagiotti GR, Leknes KN, Wikesjo UM. Oral tissue reactions to suture materials.
Int J Periodontics Restorative Dent 1998;18:474–87.
Silverstein LH. Principles of Dental Suturing. The Complete Guide to Surgical Closure.
Mahwah, NJ: Montage Media Corp; 1999:44–55.
Smith JD, Abramson M. Membranous vs endochondrial bone autografts. Arch Otolaryngol.
1974;99:203–205.
Summers RB. Anew concept in maxillary implant surgery: the osteotome technique.
Compend Contin Educ Dent 1994;15:152–60.
Summers RB. The osteotome technique. Part 2. The ridge expansion osteotomy (REO)
procedure. Compend Contin Educ Dent 1994;15:422–34.
Sykaras N, Iacopino AM, Marker VA, Triplett RG, Woody RD. Implant materials, design and
surface topographies: their effect on osseointegration. A literature review. Int J Oral
Tan WL, Wong TL, Wong MC, Lang NP. A systematic review of post-extractional alveolar
hard and soft tissue dimensional changes in humans. Clin Oral Implants Res
2012;23(Suppl 5):1–21.
Tarnow DP, Pérez JM, Ghamid SS, Manasse M, Froum SJ, Shabeesh M, Cho SC. A New
Technique to Identify the Location of the Mucogingival Junction on Computer
Tomographic Scans Before Implant Placement. Implant Dent 2015;24:338–42.
Ten Heggeler JM, Slot DE, Van Der Weijden GA. Effect of socket preservation therapies
following tooth extraction in non-molar regions in humans: a systematic review. Clin
Oral Implants Res 2011;22:779–788.
Testori T, Bianchi F, Del Fabbro M, Szmukler-Moncler S, Francetti L, Weinstein RL
Immediate Non-Occlusal Loading vs. Early Loading in Partially Edentulous Patients.
Pract Proced Aesthet Dent 2003;15:787–794.
Toriumi DM, Kotler HS, Luxenberg DP, et al. Mandibular reconstruction with a recombinant
bone-inducing factor. Functional, histologic, and biomechanical evaluation. Arch
Otolaryngol Head Neck Surg 1991;117:1101–12.
Valen M, Locante WM. LaminOss immediate-load implants. Part II. Introducing
osteocompression in dentistry. J Oral Implantol 2000;26:177–84.
Van de Velde T, Glor F, De Bruyn H. A model study on flapless implant placement by
clinicians with a different experience level in implant surgery. Clin Oral Implants Res.
2008;19:66–72.
Van den Bergj JP, ten Ruggenkate CM, Disch FJ, Tuinzing DB. Anatomical aspects of sinus
floor elevations. Clin Oral Implants Res. 2000;11:256–265. 15.
Van Der Weijden F, Dell’acqua, F, Slot DE. Alveolar bone dimensional changes of post-
extraction sockets in humans: a systematic review. J Clin Periodontol 2009;36:1048–
1058.
Velvart P Papilla base incision: a new approach to recession-free healing of the interdental
papilla after endodontic surgery. Int Endod J. 2002;35:453–60.
Velvart P, Peters CI Soft tissue management in endodontic surgery. J Endod 2005;31:4–16.
Velvart P, Peters CI, Peters OA Soft tissue management: flap design, incision, tissue
elevation, and tissue retraction. Endod Topics 2005;11:78–97.
Vignoletti, F, Matesanz P, Rodrigo D, Figuero E, Martin C, Sanz M. Surgical protocols for
ridge preservation after tooth extraction. A systematic review. Clin Oral Implants Res
2012;23(Suppl 5):22–38.
Surgical 157
von Arx T, Jenssen SS, Haenni S, Schenk RK Haemostatic agents used in periradicular
surgery: an experimental study of their efficacy and tissue reactions. Int Endod J
2006;39:800–8.
von Arx T, Vinzens-Majaniemi T, Bürgin W, Jensen SS Changes of periodontal parameters
following apical surgery: a prospective clinical study of three incision techniques. Int
Endod J. 2007;40:959–69.
Wang EA, Rosen V, D'Alessandro JS, et al. Recombinant human bone morphogenetic protein
induces bone formation. Proceed Nat Acad Sci USA 1990;87:2220–4.
Wang HL, Boyapati L. "PASS" principles for predictable bone regeneration. Implant Dent
2006;15:8–17.
Wang HL, Carroll WJ. Using absorbable collagen membranes for guided tissue regeneration,
guided bone regeneration, and to treat gingival recession. Compend Cont Edue Dent
2000; 21: 399–402.
Wittwer G, Adeyemo WL, Wagner A, Enislidis G. Computer-guided flapless placement and
immediate loading of four conical screw-type implants in the edentulous mandible. Clin
Oral Impl Res 2007;18:534–539.
Worthington P, Bolender CL, Taylor TD The Swedish system of osseointegrated implants:
Problems and complications encountered during a 4-year trial period. Int J Oral
Maxillofac Implants 1987;2: 77–84.
Yan AY.-M. Tsai, M.-Y. Wong, L.-T. Hou, Comparison of acellular dermal graft and palatal
autograft in the reconstruction of keratinized gingiva around dental implants: acasereport.
Int J Periodontic Restorative Dent 2006;26:287–292.
Zhong W, Chen B, Liang X, Ma G. Experimental study on penetration of dental implants into
the maxillary sinus in different depths. J Appl Oral Sci 2013;21:560–566.
Zijderveld SA, van den Bergh JP, Schulten EA, et al. Anatomical and surgical findings and
complications in 100 consecutive maxillary sinus floor elevation procedures. J Oral
Maxillofac Surg. 2008;66: 1426–1438.
Zola MA. Methods of designing, elevating and suturing the intraoral flap. Oral Implantol.
1972;3:5–18.
Chapter 9
PROSTHETIC
1- The lip line during smiling is divided into high, low and moderate. The percentages in
each group among the general population are:
a-High 20%, low 20%, moderate 60%
b-High 30%, low 20%, moderate 50%
c-High 10%, low 20%, moderate 70%
d-High 10%, low 30%, moderate 60%
e-High 30%, low 10%, moderate 60%
2- Factors that determine the fullness of the dental papillae in the embrasure area include:
a- abutment design
b- implant diameter
c- hemidesmosomes attachment
d- the distance between the crestal bone and the crown contact area
e- all of the above
3- In a fully edentulous upper ridge, bone resorption will be:

a- centripetal
b- centrifugal
c- inward and upward direction
d- outward and upward direction
e- a& c
4- In a fully edentulous lower ridge, bone resorption will be:

a- centripetal in the anterior region and centrifugal in the posterior region
b- centrifugal in the anterior region and centripetal in the posterior region
c- centrifugal in the anterior and posterior region
d- centripetal in the anterior and posterior region
5- Pitch refers to:

a- angulation of the threads
b- the depth of the thread
c- width of the threads
d- distance between the implant threads
6- Progressive implant loading is recommended for implants:

a- dense bone
b- with screw crown placed
c- placed in poor bone density
d- immediately placed
e- a&b
7- For coronal growth of the interimplant papillae, the crown surface should be:
a- convex
b- concave
c- flat
d- smooth
e- b&d
8- Interdental papillae loss between implants or between the implant and the tooth will
cause:
a- phonetic problem
b- aesthetic problem
c- peri- implant gingivitis
d- increasing probing depth
e- a&b
9- Disadvantage of a ridge lab crown is:

a- difficult to maintain oral hygiene
b- difficulty of probing
c- disharmonious of the gingival margins
d- compromise the desired emergence profile
e- all of the above
10- Contact between an implant and a natural tooth is discouraged because:

a- different angulation of implant and natural teeth
b- mobility differences between implants and teeth
c- retrievability would be difficult when complication happened
d- cleaning and maintaining oral hygiene would be hard
Prosthetic 161
11- Splinting multiple dental implants has been recommended to reduce load risk factors.
However, using a single unit allows:
a- better emergence profiles
b- retrievability would be easy in comparison to splinting implant
c- improved passive fit of the metal framework
d- better oral hygiene access
e- all of the above
12- The mean value for the axial mobility of the teeth is 25 to 100 µm, whereas the axial
displacement of osseointegrated implants is:
a- 20 to 50 µm
b- 20 to 30 µm
c- 20 to 25 µm
d- 3 to 5 µm
13- During lateral loading, the tooth moves at the apical third of the root, and the force is
instantly dissipated from the crest of the bone along the root. By contrast, the implant moves
10 to 50 µm laterally, and the concentration of forces is at:
a- middle third
b- coronal and apical third
c- crestal bone
d- apical third
14- General recommendations for occlusal morphology include:

a- flat fossa and grooves for wide freedom in centric
b- shallow occlusal anatomy
c- a narrow occlusal table
d- reduced cuspal inclination
e- all of the above
15- The proposed crown/implant ratio for a tissue- level implant is:
a- the length of anatomical crown (until the implant shoulder)/ implant length
b- the length of clinical crown (until the bone crest)/ implant length
c- the length of clinical crown (until the implant shoulder)/ implant length
d- a- the length of anatomical crown (until the bone crest)/ implant length
16- Occlusal materials for an implant- supported prosthesis that transmit less force to the
bone during loading include:
a- zirconia
b- acrylic
c- gold alloy
d- porcelain
e- b&c
17- Parafunctional activities have been attributed to technical and mechanical

complications, including:
a- veneering porcelain chipping
b- fracture or screw loosening
c- crown decementation
d- crestal bone resorption
e- all of the above
18- When placing posterior canine implants, guidance or protection is important because
the canine assists in:
a- guide the occlusion into centric occlusion
b- withstand more force during mastication
c- keep the posterior implant in contact during excursion movement
d- disclusion in eccentric movements
19- In cases of posterior canine implants without guidance or protection, guidance should
be replaced by:
a- anterior guidance
b- group of function occlusion
c- protrusive guidance
d- bilateral balanced occlusion
20- Occlusion adjustment for an implant prosthesis is recommended to have light contact
on a firm occlusion, meaning that:
a- shim stock (8–30 µm) passing through
b- cusp to fossa contact
c- no contact during excursion movement
d- shim stock dragging through
e- b&d
21- An implant placed too coronally in the esthetic zone will result in the following
difficulty:
a- the crown of choice is only cemented crown
b- dark shadow appear through the marginal gingiva
c- insufficient room for the crown to emerge from the tissue
d- insufficient room for porcelain
e- a&d
22- Placing an implant too deep in the esthetic zone will result in the following difficulty:
a- negatively effect on the emergence profile
b- crown look short than the contralateral tooth
c- impression can be a difficult experience
d- screw retained restoration is the treatment of choice
e- c&d
Prosthetic 163
23- For a successful immediately loaded single implant, the following should be
considered:
a- primary implant stability should be achieved
b- occlusal, working, and nonworking contacts eliminated
c- no facial bone loss or dehiscence
d- adjacent teeth should not periodontaly compromised
e- all of the above
24- Occlusal prematurities normally present as:

a- the bicuspid teeth
b- second molar teeth
c- central incisor teeth
d- canine teeth
e- b&c
25- The minimum interocclusal space needed for a posterior implant crown is:
a- 5mm from the crestal bone to the opposing occlusion
b- 5mm from the gingival tissue to the opposing occlusion
c- 7mm from the gingival tissue to the opposing occlusion
d- 8mm from the gingival tissue to the opposing occlusion
e- a&c
26- For a maxillary overdenture implant prosthesis, the minimum interarch space is:
a- 14mm
b- 12mm
c- 10mm
d- 20mm
27- The advantages of removable prostheses over the fixed in implant dentistry include
a- less number of implant needed
b- no nocturnal stress on the implant
c- preserved the bony tissue from resorption
d- better in irretrievability
e- easier in maintain the oral hygiene
28- The most common complication of a single- crown implant is:

a- implant fixture fracture
b- abutment screw fracture
c- progressive crestal bone resorption
d- abutment screw loosening
e- b&c
29- To decrease the incidence of abutment screw loosening, the following should be
considered:
a- eliminate the vertical and horizontal cantilever
b- increase abutment screw length and diameter
c- eliminate later excursion contact
d- night guard for bruxiser patient
e- all of the above
30- The upper arch shape can be change from a u to a square if:
a- muliple extraction of 6 anterior teeth
d- congenital missing of 2 lateral incisors
c- early extraction of 4 incisors and persistence of canines
d- early extraction of canines and persistence of 2 laterals incisors
31- In moderate occlusion, the ratio of the anterio- posterior implant distance to the
cantilever length equals:
a- 1:1
b- 1:2
c- 2:1
d- 1:1.5
32- For a posterior cantilevered prosthesis, the anterio- posterior implant distance is
measured from:
a- the distal surface of the most distal implant to the central of the anterior implant
b- the mesial surface of the most distal implant to the central of the anterior implant
c- the distal surface of the most distal implant to the distal of the anterior implant
d- the central of the most distal implant to the central of the anterior implant
e- the mesial surface of the most distal implant to the distal of the anterior implant
33- The indication for a cemented crown is:

a- sever angulated implant
b- gingival or supragingival abutment margin
c- multiple implant with different angulation
d- palataly placed implant
e- all of the above
34- The indication for a screw crown is:

a- limited inter arch space
b- subginigval abutment margin
c- angled anterior implant
d- bruxer patient
e- a&b
Prosthetic 165
35- If an implant over denture moves in a different direction, the operator determines the
denture movement based on:
a- anterio- posterior distance
b- bone availability
c- number of implant
d- shape of the dental arch
e- b&c
36- Which arch shape is more favorable for a long posterior cantilever in an edentulous
arch:
a- square arch shape
b- U- arch shape
c- tringular arch shape
d- tapered arch shape
37- The advantage of a bar- connecting implant over an individual loaded (stud) implant
in an implant overdenture is:
a- with the bar can connect different angulated implant
b- less maintenance needed
c- stress loading can be distributed on many implant
d- allow for better movement during loading
e- all of the above
38- Immediate loading of an interforamina implant placed in the lower edentulous is

common, but the following should be considered:
a- implants should be connected together
b- achieve good primary implant stability
c- implant placed in dense bone
d- cantilever should minimized or eliminated
e- all of the above
39- Mechanical risk in implant dentistry refers to:

a- cantilever prosthesis
b- 1:2 implant to crown ratio
c- soft bone
d- bruxser patient
e- all of the above
40- The passive fitness of a super structure screw- retained bar can be verified through:
a- single screw method
b- fitness of the over denture
c- pain symptoms for unfitted bar
d- unfited bar show increase in the occlusal vertical dimension
41- The advantage of a hex abutment is:

a- decrease subginigval cement leakage
b- provide antirotation mechanism which can decrease screw loosening
c- more precise fitness with the implant
d- decrease stress to the adjacent crestal bone
e- b&c
42- The sign of an overloaded implant is:

a- abutment screw loosening
b- crown decementation
c- progressive crestal bone resorption
d- crown porcelain chip of
e- all of the above
43- A one- piece abutment has the advantage of:

a- elimenate abutment screw loosening problem
b- can be used in direct and indirect abutment preparation
c- angled implant
d- for better emergence profile
e- all of the above
44- The advantage of an individual loaded (stud) implant over a bar- connecting implant
in an implant overdenture is:
a- less cost
b- less restorative space required
c- improve hygiene access
d- doesn’t needs high level of lab work
e- all of the above
45- In a case of a fully edentulous patient who needs an implant overdenture but has a
limited occlusal vertical dimension, the best treatment approach is:
a- screw retained bar rather than cemented
b- open the patient vertical dimension
c- lowering the alveolar ridge by osteotomy
d- fabricate a denture over a stud
e- all of the above
46- The primary support area in the maxillary edentulous ridge is:
a- posterior ridge
b- rugae area
c- flat area of the palate
d- anterior ridge
e- a&c
Prosthetic 167
47- The primary support area in the mandibular edentulous ridge is:
a- mylohyoid ridge
b- buccal shelf area
c- anterior ridge
d- posterior ridge
e- b&d
48- A tray for the upper edentulous arch should cover:

a- hamular notch
b- retromolar area
c- part of the soft palate
d- maxillary tuberosity
e- a&d
49- A tray for the lower edentulous arch should cover:

a- external oblique ridge
b- internal oblique ridge
c- retromolar pad
d- ptyrego- mandibular raphe
e- a&d
50- The mucostatic impression technique refers to:

a- taking the impression under compression
b- taking the impression with border moulding
c- to register the functional mobile tissue
d- impression taken during patient smiling and pouching
51- The functional impression technique refers to:

a- impression technique of tissue under different degrees of mobility
b- impression registration the basal seat
c- impression register the implant post area
d- mucostatic impression registration
e- b&c
52- The best type of soft tissue to support a removable prosthesis is:
a- none- keratinized mucosa
b- lining mucosa
c- flappy
d- keratinized mucosa
53- The goal of placing tissue stops in a customized impression tray is to:
a- create a space on the future denture
b- create adequate space for the impression material
c- prevent over seating of the tray
d- to allow registration of the basal seat more accurately
e- b&c
54- For a lower arch implant over a denture impression, the following anatomical
structure should be recorded:
a- retromolar pads
b- all frena attachments
c- vestibular sulcus
d- retro mylohyoid space
e- all of the above
55- The following factor is critical when taking an impression of equigingival and
subgingival abutment margins:
a- hemostasis
b- gingival retraction
c- ginigval biotype
d- abutment angulation
e- a&b
56- The single cord technique for a gingival retraction procedure is indicated when:
a- deep subgingival margin
b- equigingival and suprgingival margin
c- thick gingival tissue
d- friable tissue
e- b&d
57- A custom tray has advantages over a stock tray:

a- enable better impression–material flow
b- accurate impressions
c- less impression material
d- more comfortable for patients
e- all of the above
58- The criteria for the impression material selected for implant crown and bridge
fabrication are:
a- dimensionally stable for a reasonable time needed
b- adequate working time
c- flowability
d- sufficient tear strength
e- all of the above
Prosthetic 169
59- Impression material flowability is affected by:

a- impression material working time
b- surface contact angle
c- hydrophilicity and wettability
d- type of the surface
e- all of the above
60- The precision of an impression material is required to replicate:

a- 5- micron line
b- 20- micron line
c- 40- micron line
d- 50- micron line
e- 30- micron line
61- Patients with sleep bruxism have signs or symptoms of:

a- jaw pain
b- limitation mouth opening
c- headache
d- abfraction teeth
e- all of the above
62- The more favorable mouth guard design for protection of the posterior implant in a
patient with sleep bruxism is one that covers the anterior teeth and may allow occlusal contact
on the incisor teeth:
a- to increase the activity of the muscle of mastication
b- to increase the vertical occlusal dimension
c- to guide the patient for the new safe occlusion
d- elevator muscle activity is decreased while clenching on an anterior teeth contact only
e- b&c
63- During fabrication of a mouth guard to protect the posterior implant in a patient with
sleep bruxism, the following should be checked:
a- bite registration
b- ensure that with all excursive movements the incisors remain in contact with the
occluding
c- maximum protrusive distance
d- vertical measurement
e- all of the above
64- A soft mouth guard is not recommended for a patient with sleep bruxism because:
a- difficult to fit precisely
b- dimensional change in hot and cold
c- may increase bruxism
d- fructure easily
e- all of the above
65- The type and design of a prosthesis for an upper edentulous arch are affected by:
a- number of the implant
b- lip line
c- vertical occlusal distance
d- bone availability
e- all of the above
66- The type and design of a prosthesis for a lower edentulous arch are affected by:
a- interforaminal distance
b- anterio- posterior implant distance
c- vertical occlusal distance
d- bone availability
e- all of the above
67- The gingival zenith of the upper lateral incisor is located:

a- below canine and with the same level of the central incisor
b- below canine and central incisor
c- above central incisor and with same level of canine
d- above central incisor and canine
68- The gingival zenith position for the lateral incisors shows a mean average of 0.4 mm.
The canine tooth group demonstrates almost no deviations of the zenith position from the
midline of the tooth, while for the central incisors:
a- 1 mm distal from the vertical mid line
b- no deviation from the mid line
c- 0.2mm mesial from the vertical mid line
d- 1 mm mesial from the vertical mid line
69- A provisional fixed restoration in a dental implant has all of the following advantages
except:
a- guides peri- implant soft- tissue healing
b- patient aesthetic satisfaction
c- enhance implant stability and osseointegration
d- improve patient adaptation for the new prosthesis
e- reduce the treatment period and surgeries
70- Using the patient’s existing removable complete denture prosthesis to fabricate the
immediate fixed provisional restoration will provide:
a- prevent over loading of the implant
b- occlusal contacts and vertical dimension guidance
c- consume time
d- maintain patient aesthetic
Prosthetic 171
71- Repeated abutment dis/reconnections at short intervals will cause:

a- abutment screw disfigurement
b- compromise the mucosal barrier
c- gap creation between the abutment and implant shoulder
d- crestal bone level changes
e- b&d
72- A major advantage of zirconium dioxide over conventional Ti abutments is:

a- casting fitness
b- strength
c- aesthetic benefits
d- reduced bacterial adhesion
e- c&d
73- Undetected cement excess during cementation will be affected by:

a- crown shape
b- abutment angulation
c- abutment design
d- the marginal level of the abutment
e- all of the above
74- To reduce the dimensional changes during an impression procedure, the following
impression material is recommended:
a- alginate
b- zinc phosphate
c- additional silicone
d- condensation silicone
e- polyether
75- To reduce the dimensional changes during a cast fabrication procedure, the following
material is recommended:
a- die type I
b- die type II
c- die type III
d- die type IV
e- epoxy
76- The purpose of the buccal groove on a solid abutment is:

a- act as a crown resistance measure
b- to accommodate the excess cement
c- to prevent mesiodistal crown dislodgment
d- is to prevent bucco- lingual crown dislodgment
77- Which of the following can decrease the stress and resorption on crestal bone:
a- cemented crown
b- screw crown
c- one piece abutment
d- mutiple piece abutment
e- a&c
78- The advantage of a distal cantilever in a fully edentulous arch is:

a- reduce expenses
b- reduce treatment time
c- avoid extensive surgical procedures
d- avoid vital anatomical structures
e- all of the above
79- A poor fit between the framework and the implant has been shown to cause
mechanical and biological complications, including:
a- loosening of the framework prosthetic and abutment screws
b- marginal bone loss
c- fracture of the various prosthetic components
d- pain and tenderness
e- all of the above
80- Factors that affect prosthetic framework distortion include:

a- implant level
b- impression technique
c- abutment type
d- increase the length of the prosthesis
e- all of the above
81- For a lower overdenture prosthesis on 2 implants, the implant position should be:
a- premolar area
b- canine area
c- lateral incisors
d- central incisors
e- one on canine and another one on lateral incisor area
82- An overdenture prosthesis is not recommended in young patients because:

a- aesthetically unpleasant
b- continuous bone resorption
c- adaptation would be difficult
d- lack of sufficient occlusal vertical dimension
e- all of the above
Prosthetic 173
83- The attachment for a Hader bar requires ___________ space between it and the
adjacent implant:
a- 4mm
b- 6mm
c- 3mm
d- 2mm
84- The highest force exerted during occlusion occurs when a dental implant opposes:
a- natural teeth
b- removable denture
c- dental implant
d- fixed prosthesis
85- According to the normal occlusal scheme, the only teeth subjected to angulated
loading during closure are:
a- lower anterior teeth
b- upper premolars
c- lower premolars
d- lower first molar
86- Regarding the subperiosteal implant, all of the following are true except:
a- indicated only in the complete edentulous ridges
b- more predictable in the mandible
c- indicated in lower square arch form
d- extend to the ramus for primary support
e- eliminate cantilevers in the posterior of prosthesis
87- An increase or decrease in the occlusal vertical dimension in a fully edentulous

patient can affect:
a- patient face profile
b- direction of occlusal force
c- mandibular- maxillary jaw relationship
d- patient speech
e- all of the above
88- To increase the crown height space in an implant site, the following can be
performed:
a- enameloplasty of the opposing tooth
b- alveoloplasty at the time of surgery
c- soft tissue reduction for the thick gingival tissue
d- subgingival crown margin and/or subcrestal implant placement
e- all of the above
89- factor that can determine the length of a posterior cantilever section on a fully
edentulous prosthesis include:
a- parafumction patient occlusion
b- bone density
c- increase in crown height space
d- opposing arch
e- all of the above
90- For a fully upper edentulous patient with reduced ridge height and a high smile line,
the best treatment approach is:
a- hybrid prosthesis with pink porcelain
b- bone graft augmentation in width and height dimension and place implant in optimum
condition
c- porcelain fused to metal bridge on implant with long crowns
d- acrylic over denture on implant
e- b&d
91- A temporization plan for a fully edentulous patient can be implemented by using:
a- remaining natural teeth (before extraction) as transitional abutment
b- over denture on mini implant
c- conventional denture
d- immediate denture on implant (additional implant placed for immediate loading, while
the rest is submerged)
e- all of the above
92- The cantilever in a posterior partial edentulous bridge should follow the principle of:
a- cantilever placed anterior rather than posterior
b- the distance of the cantilever should be less than the distance between 2 adjacent
implant
c- no parafunctional occlusion
d- all of the above
93- To increase the mobility of a mandibular implant overdenture, the following should
be used:
a- bar with clip attachment
b- independent O- ring attachment
c- attachment placed in angle to the bath of movement
d- use golden attachment
e- a&c
Prosthetic 175
94- To decrease the mobility for of a mandibular implant overdenture, the following
should be used:
a- bar with clip attachment
c- attachment placed in angle to the bath of movement
d- bar with O- ring attachment
e- a&c
95- To increase the vertical movement of a mandibular implant overdenture, the

following should be used:
a- dolder bar with spacer
b- hader bar with O- ring
c- independent O- ring
d- hader bar with clip attachment
e- b&c
96- Increasing the mobility of a mandibular implant overdenture is recommended when:

a- sufficent number of implant
b- tapered arch form
c- insufficient posterior ridge support
d- sufficient posterior ridge support
e- a&b
97- Factors that might affect the movement of a removable implant overdenture include:
a- type of attachment
b- type and shape of the posterior ridge
c- direction of the clip attachment
d- number of implant and implant position
e- all of the above
98- To reduce the stress on the implant in a lower fully edentulous patient treated with an
implant overdenture, the following should be considered:
a- the implant should be connected to a bar
b- allow more denture movement and rotation
c- loading with long axis of the implant
d- allow soft tissue support and minimise cantilever
e- all of the above
99- The disadvantages of a bar super structure compared to the independent stud or O-
ring overdenture implant in a fully edentulous ridge include all of the following except:
a- increase stress on the individual implant
b- need more crown height space
c- gingival over growth under the bar and difficult to clean
d- higher cost
e- technique sensitive and difficult to achieve passive fitness
100- The advantage of a Hader bar is:

a- allow denture vertical movement
b- allow more denture movement and rotation
c- need less crown height space
d- more flexible
e- a&d
101- The indication for a direct impression technique (abutment level) is:
a- in customised abutment case
b- implant overdenture
c- supra gingival level abutment
d- for esthetic need
e- all of the above
102- Factors that affect the superstructure bar design (O- ring vs. clip attachment)
include:
a- number of implant
b- crown height space
c- type and amount of denture movement
d- type of bar system
e- b&c
103- The muscle that is responsible for the mandible torque movement during closure is:
a- medial pterygoid muscle
b- masseter muscle
d- temporalis muscle
e- a&d
104- For an anterior cantilever estimate in a fully edentulous maxillary ridge, the AP
distance is measured from ___________ to ___________:
a- the posterior aspect of the most distal implant to the anterior aspect of the most anterior
implant
b- the center of the most distal implant to the center of the most anterior implant
c- the center of the most distal implant to the anterior aspect of the most anterior implant
d- the anterior aspect of the most distal implant to the anterior aspect of the most anterior
implant
e- the posterior aspect of the most distal implant to the posterior aspect of the most
anterior implant
Prosthetic 177
105- The most favorable arch form in the anterior cantilever of an upper edentulous ridge
with less stress is:
a- square arch form
b- tapered arch form
c- oval arch form
d- triangular
e- a&b
106- Placing the implant in the premaxillary edentulous area (Kennedy class IV) has the
following risk:
a- palatal placed implant
b- increase in the crown height space
c- soft bone and thin buccal plate
d- corwn would be subjected to angulated force
e- all of the above
107- In pronunciation the linguoalveolar letter is:

a- V
b- N
c- J
d- T
e- G
108- To determine the relationship between the upper lip level during resting and the
upper anterior teeth, the following tooth should be used as a guide:
a- first premolar
b- central incisor
c- canine
d- lateral incisor
e- d&b
109- The guide for positioning the upper central incisor in an edentulous maxilla is its
relationship to the incisive foramen, which is:
a- 12.5mm from the posterior border
b- 12 from the anterior border
c- 10 mm form the anterior border
d- 13 from the anterior border
e- 10mm from the posterior border
110- Reverse smile occurs when:

a- lateral incisor does not show during maximum smiling
b- lateral incisor occupied more space than the canine during smiling
c- lateral incisor occupied more space than central incisor during smiling
d- central incisor occupied more space than lateral incisor during smiling
e- canine occupied more space than central incisor during smiling
111- Camper’s line refers to:

a- line drawn between two hamular notch
b- ala- tragal line in the orthognathic profile patient
c- inter pupil line
d- line drawn from the tip of the lower canine to the retromolar area
112- At the time of implant restoration, which of the following criteria should exist:
a- implant ridgidity
b- keratinized tissue collar
c- probing depth should be less than 4mm
d- the distance between the crestal bone and abutment shoulder is within 1.5mm
e- all of the above
113- All of the following should be consider during the prosthetic stage for an implant in
the esthetic zone except:
a- esthetic abutment
b- start with provisional crown before the definite for gingival growth enhancement
c- anatomical customized abutment
d- abutment level impression after abutment preparation
e- subginival crown margin
114- Prosthetic preventive measures to decrease abutment screw loosening include all of
the following except:
a- screw stretching (repeated tighten and loosening)
b- bone level implant should be chosen
c- abutment screw should be long and large
d- hex abutment should be chosen
e- prevent angulated force
115- The advantages of a single- tooth implant replacement over other prosthetic options
include all of the following except:
a- patient can maintain better oral hygiene
b- enhance the efficacy of mastication of the posterior teeth
c- less invasive and time consuming
d- preserve bone from resorption
e- preserve tooth structure of the adjacent sound teeth
116- For a posterior single implant, the abutment of choice is:

a- hex 2 pieces abutment
b- non hex 2 pieces abutment
c- one piece abutment
d- zirconia abutment
e- UCLA abutment
Prosthetic 179
117- The midline in an edentulous patient should be:

a- in the mid of the philtrum
b- mid of the incisive papillae
c- achieve parallelism with long axis of the face
d- perpendicular to the incisal plane
e- all of the above
118- An implant in the esthetic zone may be placed more palatally because:
a- narrow bone ridge
b- cemented retained crown
c- achieve the emergence profile
d- screw retained crown
e- a&d
119- The drawback of shallow implant placement (less than 3 mm from the marginal
gingiva) in the esthetic zone is:
a- crestal bone resorption
b- sever emergence profile angle
c- ridge lab crown
d- gingival recession
e- all of the above
120- The drawbacks of deep implant placement (more than 3 mm from the marginal
gingiva) in esthetic zone include all of the following except:
a- increase sulcular depth
c- short emergence profile distance
e- increase crown length
121- According to Kois, the five diagnostic elements required before immediate
placement of an implant in the esthetic zone include all of the following except:
a- tooth position
b- level of the alveolar crest before extraction
c- tooth shape
d- root shape
e- gingival biotype
122- The drawback of immediate implant placement in the esthetic zone is:
a- perforation of the palatal plate during implant osteotomy and implant placement
b- implant would not be placed in the optimum position
c- unstable gingival margin end with recession
d- always need for bone grafting to maintain the buccal plate
e- all of the above
123- The advantages of immediate implant placement in the esthetic zone include all of
the following except:
a- palatal implant position enhance emergence profile of the crown
b- prevent bone and soft tissue from collapse
c- consume the time and cost
d- decrease the chance of hard and soft tissue augmentation in the future
e- more conservative and none invasive surgery (flapless)
124- Factors affecting abutment selection in the esthetic zone include:

a- gingival biotype
b- implant position
c- smile line
d- implant angulation
e- all of the above
125- The disadvantage of an anatomical abutment design is:

a- does not provide enough space for emergence profile
b- abutment flaring widely above implant
c- same diameter as implant
d- provide less surface for abutment preparation
e- a&d
126- In the esthetic zone, knife- edge abutment preparation can be performed in the
following case:
a- thick gingival tissue
b- thin gingival tissue
c- facial placed implant
d- palatal placed implant
e- a&d
127- The following measure can help reduce the chance of subgingival existence of
cement material during crown cementation:
a- placement of the retraction cord before cementation
b- gingival and supragingival margin of abutment is recommended
c- chamfer abutment finish line provide more space
d- less hard cement material (none resin cement)
e- all of the above
128- The indication for a one- piece abutment is:

a- when anatomical abutment needed
b- sever implant angulation
c- multiple unite implants
d- single implant
e- b&c
Prosthetic 181
129- The advantage of a one- piece implant is:

a- better fitting to the implant shoulder
b- give more space for preparation
c- engage to the implant hexagon
d- more compatible with lab work
e- a&b
130- The abutment surface and design should avoid the following:
a- flat surfaces
b- rounded and tapered design
c- smooth surfaces
d- limiting the path of insertion of crown
e- b&c
131- The disadvantage of the direct impression technique (abutment level) is:
a- precise registration of the abutment margin in 3600 is mandatory
b- difficult to register the subginigval margin abutment
c- risk of abutment break during the removal of the impression from the cast
d- impression material may extend beyond the abutment margin
e- all of the above
132- The selection of the cement material for a cemented crown depends on:
a- number of unite need to be cemented
b- type of abutment material
c- prosthetic design
d- easy of excess removal and working time
e- all of the above
133- The abutment screw loosens because:

a- screw factor (design, size, length, pretourque)
b- prosthetic factor (fitness of the prosthesis, design, cantilever, crown height space)
c- force factor (direction, magnitude, cycle)
d- implant factor (width, annulus design, hex or none, number)
e- all of the above
134- Cemented and screw crown prostheses are fabricated at the level of:
a- cemented at the level of abutment while screw is at the level of implant
b- both of them at the level of the implant
c- both of them at the level of abutment
d- cemented at the level of implant while screw is at the level of abutment
135- An unfit abutment leads to a gap between the abutment and implant that may cause:
a- crestal bone resorption
b- accumulation of bacteria
c- abutment screw loosening
d- fructure of the abutment or its screw
e- all of the above
136- The advantage of a cemented prosthesis over a screw- retained prosthesis is:
a- more esthetic for crown in the esthetic zone
b- can fit more passively
c- less lab technique sensitive
d- provisional crown with anatomical abutment can enhance soft tissue contouring
e- all of the above
137- The advantages of a screw- retained prosthesis over cemented one include all of the
following except:
a- can be fabricated with less crown height space
b- easier in retrievability
c- more safe for the adjacent soft tissue
d- decrease stress to the underlying abutment
e- eliminate the problem of unfitted crown on the abutment due to cement factor
138- When replacing a fully edentulous upper with an implant opposing natural teeth, the
occlusion scheme is:
a- regenerative occlusion
b- compensating occlusion
c- related occlusion
d- follow occlusion
139- The occlusion rehabilitation in an implant patient differs from natural teeth
occlusion, even in a normal occlusion patient, because:
a- limited crown height space
b- implant- bone relation
c- bone resorption
d- implant angulation
e- c&d
140- For the occlusion of a single posterior implant, all of the following should be
considered except:
a- health and mobility of the adjacent teeth
b- cusp to fossa relation of the adjacent teeth and implant
c- compensating curve
d- canine guidance
e- surface anatomy of the implant crown
Prosthetic 183
141- For the occlusion of an upper anterior single implant, all of the following should be
considered except:
a- group of function occlusion
b- over bite
c- incisal guidance
d- canine guidance
e- cingulum position in centric occlusion for the implant crown
142- In a case of a single upper canine replacement, the occlusal scheme should consider
a- no contact on protrusive
b- no contact on excusive movement
c- contact on centric occlusion
e- premolar and lateral incisor will contact during excursive movement instead of canine
143- For a partially edentulous posterior replaced with an implant with missing canine
guidance, the solution for excursion movement is:
a- incisal guidance
b- anterior guidance
c- centric occlusion
d- group of function
e- a&c
144- When replacing a fully edentulous upper with a fixed hybrid prosthesis with
implants opposing natural teeth, the occlusion contact should be on:
a- shim stock stop on posterior teeth
b- shim stock pass through the anterior teeth
c- shim stock dragging on premolar region
d- cusp to fossa relation in the posterior teeth
e- all of the above
145- Factors that may affect the occlusion of a dental implant include all of the following
except:
a- patient occlusion in centric and parafunction
b- implant angulation
c- type of agonist teeth (natural teeth, denture, implant)
d- position of the implant (anterior vs posterior)
e- type of prosthesis (movable, fixed, cantilever, partial, complet)
146- The criteria for an upper molar crown implant include all of the following except:
a- reduce the lingual contour to prevent offset load
b- central fossa placed above the implant
c- buccal cusp should be above the implant for better emergence profile
d- buccal should in in line with adjacent teeth for hygiene and esthetic purpose
e- occlusion contact on the central fossa
147- For immediately loaded implants the prosthetic design should consider all of the
following except:
a- eliminate any cantilever
b- night guard for parafunctional forces
c- loading only with the long axis of the implant
d- wider occlusal table
e- cross arch connecting implants
148- The advantage of the concept of “one time one abutment” is:
a- enhance the stability of the soft tissue around implant
b- prevent crestal bone resorption
c- achieve better hemidesmosomes attachment between the abutment and surrounding
attached gingival tissue
d- with provisional crown modification can shape marginal gingiva and interimplant
papillae
e- all of the above
149- Regarding a compensating curve in a fully edentulous occlusion, all of the following
are true except:
a- mimics the curve of Spee in natural teeth
b- mimics curve of Wilson in natural teeth
c- can achieve bilateral balance occlusion
d- the greater the incisal guidance the shallow the compensating curve
e- a&c
150- Regarding an upper removable fully edentulous denture that opposes an implant
prosthesis, all of the following should be considered except:
a- compensating curve in the posterior teeth
b- in excursion movement, anterior and posterior teeth should be in contact
c- during protrusive movement posterior teeth should be separate away and only anterior
teeth come in contact
d- palatal cusp only come in contact in the central fossa of lower teeth
e- no anterior teeth contact in centric occlusion
151- To decrease the steepness of the incisal guidance in an upper removable denture
opposing an implant prosthesis, the following guidelines should be followed:
a- increase the overjet and decrease the overbite
b- decrease the overjet and increase the overbite
c- decrease the overjet only
d- increase the overbite only
Prosthetic 185
152- A patient who underwent a replacement of six upper anterior teeth with an implant
with a fixed bridge crossing the arch returned complaining of pain in the implant and a
headache. This complication and symptoms are due to:
a- miss fit of the bridge
b- pontic impinge on the soft tissue
c- nasal floor perforation
d- impede the flexion of the mid- palatal suture, that impedes the flexion of the other
cranial bones (cranial rhythm)
153- The reasons for using temporary cement before permanent cement for definite
crown and bridge prostheses on implants include all of the following except:
a- for any pain and discomfort after prosthesis issue visit
b- to choose the proper permanent type of cement in the future
c- to avoid stress on implant on the early stage
d- for aesthetic purpose (patient desire to change the color and tooth shape)
e- any occlusion discrepancies can be readjusted in the future
154- Prosthodontists prefer keratinized mucosa over non- keratinized mucosa around
dental implants because:
a- colour harmony
b- can mask the metal shadow of abutment
c- abutment margin can be precisely located
d- give more support and can be retracted during impression procedure
e- c&d
155- In cases of an implant overdenture, the prosthetic overstructure may decrease the
freeway space and lead to:
a- phonetic problem
b- aesthetic problem
c- functional problem
d- occlusal problem
e- all of the above
156- Abutment screw loosening is a common complication and has been reported with a
single crown in:
a- premolar
b- canine
c- incisors
d- molar
e- a&d
157- An ill- fitting implant framework may lead to biological complications, include all
of the following except:
b- marginal bone loss
c- loss of integration
d- tenderness
e- pain
158- Excess cement on the implant or the surrounding soft tissues may cause a peri-
implant infection or inflammation. The etiology may be:
a- acidic content of the cement
b- rough surface of the cement that retained bacteria
c- mechanical irritant of the surrounding periodontal tissue
d- excess cement will leave crown open margin that accumulate bacteria
159- The advantages of a cement- retained prosthesis over a screw- retained prosthesis
include:
a- better marginal fit
b- no adverse tissue reaction
c- lower bleeding index
d- less peri- implant bone loss
e- c&d
160- The advantages of a digital impression over a conventional one include all of the
following except:
a- minimize distortion of impression materials
b- cost and time consuming
c- register the intraoral situation at early stages of osseointegration without disturbing the
implant component
d- can scan the transmucosal abutment part
e- need less skill and experience
161- Advocate for keeping teeth vs extracting and placing implants because teeth
provide:
a- proprioception
b- more resistance to oral pathology
c- adaptation under mechanical forces
d- esthetic
e- a&c
Prosthetic 187
162- Advocate for extracting teeth and placing implants when all of the following are true
except:
a- poor tooth prognosis
b- poor oral hygiene patient
c- loss of function
d- cost to maintain the tooth
e- sever traumatized tooth
163- Factors influencing the decision to preserve or extract teeth include all of the
following except:
a- patient habit
b- patient medical condition
c- restorative factor
d- periodontal disease severity
e- endodontic factor
164- Strategic teeth in prosthodontics include:

a- first molar
b- second molar
c- central incisor
d- canine tooth
e- a&d
165- A concave transmucosal design (negative transmucosal profile) for implant

abutments made entirely of biocompatible materials will induces include all of the following
except:
a- increase thickness of soft tissue
b- more coronaly placed junctional epithelium
c- immobilizes the soft tissues
d- creating a mucosal O- ring that nonsurgically improves the biotype
e- allows more volume for the three dimensional biological space
166- A slightly overcontoured crown may have temporarily effects, with an ischemic
reaction (white soft tissue) for approximately ________________ . After this, the soft tissue
should returned to its pink color
a- 10 to 15 minutes
b- 2 to 3 hours
c- 6 to 12 hours
d- 24 to 36 hours
e- 40 to 60 minutes
167- Factors affecting abutment selection in the nonesthetic zone include:

a- healing abutment diameter
b- implant diameter
c- gingival thickness
d- gingival height
e- a&d
168- The failure of complete seating of the crown during cementation is caused by:
a- tight proximal contact
b- inadequate cement space
c- inadequate pressure application while seating the crown
d- not following cement manufacturer’s recommendations setting time
e- all of the above
169- Tissue conditioners are more resilient than soft liners, but soft liners are preferred
because:
a- reduces the transmitted forces on the underlying tissues by 20% to 40%
b- no need for denture relief
c- serve for several weeks
d- acting as a cushion
e- all of the above
170- The overdenture thickness should be a minimum of ________________ to ensure

that enough denture material exists to accommodate the attachment and housing complex
(LOCATOR)
a- 3mm
b- 6mm
c- 4mm
d- 8mm
171- In multiple implant placements, the implant depth differences can be handled by
using abutments of different lengths. The depth difference should be limited to:
a- 4mm
b- 5mm
c- 3.5mm
d- 2mm
Prosthetic 189
172- For a fixed restoration in a fully edentulous maxilla, the implants must be placed
directly under the teeth. For a bar- retained prosthesis, the implants must be placed more
palatally because more space is needed for the bar:
a- both sentences are correct
b- first sentence is correct while the second is incorrect
c- first sentence is incorrect and the second one is correct
d- both sentences are incorrect
173- When a dual- scan method is planned for an existing, well- fitted denture, the
following should be performed:
a- acrylic denture impregnated with 10% to 20% barium sulfate
b- the denture is duplicated in clear acrylic
c- radiopaque markers in the labial and palatal flanges
d- radiopaque markers in the labial flange only
e- b&c
174- For bar overdenture in a fully edentulous maxilla, from prosthetic point of view, the
reason for not placing an implant in the central incisor area is:
a- decrease anterior- posterior distance
b- avoid excessive bar bulk under the anterior maxilla
c- decrease occlusal vertical dimension
d- end with protrusive teeth
e- all of the above
175- For a bar overdenture in a fully edentulous maxilla, the factors that may lead to
frequent denture fractures include all of the following except:
a- occluding against natural teeth
b- when the implant are placed more palatal
c- insufficient space for the acrylic material
d- occluding against implant supported prosthesis
e- when the denture teeth are protrusive
176- proposed bar overdenture has been recommended for a patient with a fully
edentulous maxilla. However, due to financial limitations, the patient wishes to have a fixed
prosthesis. Based on this, how should the implants be placed:
a- underneath the teeth
b- more palatal
c- avoid embrasure
d- submerged technique
e- a&c
177- The angled implant is not favorable from a mechanical point of view during loading
but can still offer some advantages, including all of the following except:
a- eliminates the need for distal cantilevers
b- allow load distribution throughout the arch
c- less stress on the crestal bone
d- can use long implant that engage more cortical bone
e- viable alternative to bone grafting procedure
178- Zygomatic implants should be connected rigidly to the anterior implants shortly
after exposure because:
a- probably integrate only zygomatic bone and not the palatal bone
b- to eliminate the anterior cantilever
c- sever angulation of the zygomatic implant
d- probably integrate only palatal bone and not the zygomatic bone
e- b&c
179- An implant placed in a vertical height diminished ridge will end with all of the
following except:
a- short implant
b- narrow implant
c- long crown
d- less keratinized tissue and more movable soft tissue
e- vertical cantilever is increased
CORRECT ANSWER
Q1
a- High 20%, low 20%, moderate 60%
Q2
d- the distance between the crestal bone and the crown contact area
Q3
a- centripetal
Q4
a- centripetal in the anterior region and centrifugal in the posterior region
Q5
d- distance between the implant threads
Q6
c- placed in poor bone density
Prosthetic 191
Q7
e- b&d
Q8
e- a&b
Q9
e- all of the above
Q10
b- mobility differences between implants and teeth
Q11
e- all of the above
Q12
d- 3 to 5 µm
Q13
c- crestal bone
Q14
e- all of the above
Q15
a- the length of anatomical crown (until the implant shoulder)/ implant length
Q16
e- b&c
Q17
e- all of the above
Q18
d- disclusion in eccentric movements
Q19
b- Group of function occlusion
Q20
a- shim stock (8–30 µm) passing through
Q21
c- insufficient room for the crown to emerge from the tissue
Q22
e- c&d
Q23
e- all of the above
Q24
a- the bicuspid teeth
Q25
b- 5mm from the gingival tissue to the opposing occlusion
Q26
a- 14mm
Q27
c- preserved the bony tissue from resorption
Q28
d- abutment screw loosening
Q29
e- all of the above
Q30
c- early extraction of 4 incisors and persistence of canines
Q31
d- 1:1.5
Q32
a- the distal surface of the most distal implant to the central of the anterior implant
Q33
e- all of the above
Q34
e- a&b
Q35
e- b&c
Q36
d- tapered arch shape
Prosthetic 193
Q37
e- all of the above
Q38
e- all of the above
Q39
e- all of the above
Q40
a- single screw method
Q41
e- b&c
Q42
e- all of the above
Q43
a- elimenate abutment screw loosening problem
Q44
e- all of the above
Q45
e- all of the above
Q46
e- a&c
Q47
e- b&d
Q48
e- a&d
Q49
c- retromolar pad
Q50
e- none of the above (impression technique of undisturbed and uncompressed tissue)
Q51
a- impression technique of tissue under different degrees of mobility
Q52
d- keratinized mucosa
Q53
e- b&c
Q54
e- all of the above
Q55
e- a&b
Q56
e- b&d
Q57
e- all of the above
Q58
e- all of the above
Q59
e- all of the above
Q60
b- 20- micron line
Q61
e- all of the above
Q62
d- elevator muscle activity is decreased while clenching on an anterior teeth contact only
Q63
e- all of the above
Q64
c- may increase bruxism
Q65
e- all of the above
Q66
e- all of the above
Prosthetic 195
Q67
b- below canine and central incisor
Q68
a- 1 mm distal from the vertical mid line
Q69
c- enhance implant stability and osseointegration
Q70
b- occlusal contacts and vertical dimension guidance
Q71
e- b&d
Q72
e- c&d
Q73
d- the marginal level of the abutment
Q74
c- additional silicone
Q75
d- die type IV
Q76
c- to prevent mesiodistal crown dislodgment
Q77
e- a&c
Q78
e- all of the above
Q79
e- all of the above
Q80
d- increase the length of the prosthesis
Q81
a- premolar area
Q82
b- continuous bone resorption
Q83
b- 6mm
Q84
c- dental implant
Q85
e- none of the above (upper anterior teeth)
Q86
a- indicated only in the complete edentulous ridges
Q87
e- all of the above
Q88
e- all of the above
Q89
e- all of the above
Q90
e- b&d
Q91
e- all of the above
Q92
e- all of the above
Q93
Q94
e- a&c
Q95
a- dolder bar with spacer
Q96
c- insufficient posterior ridge support
Prosthetic 197
Q97
e- all of the above
Q98
e- all of the above
Q99
a- increase stress on the individual implant
Q100
c- need less crown height space
Q101
d- for esthetic need
Q102
e- b&c
Q103
b- masseter muscle
Q104
c- the center of the most distal implant to the anterior aspect of the most anterior implant
Q105
a- square arch form
Q106
e- all of the above
Q107
d- T
Q108
c- canine
Q109
a- 12.5mm from the posterior border
Q110
c- lateral incisor occupied more space than central incisor during smiling
Q111
b- ala- tragal line in the orthognathic profile patient
Q112
e- all of the above
Q113
d- abutment level impression after abutment preparation
Q114
b- bone level implant should be chosen
Q115
c- less invasive and time consuming
Q116
a- hex 2 pieces abutment
Q117
e- all of the above
Q118
e- a&d
Q119
b- sever emergence profile angle
Q120
c- short emergence profile distance
Q121
d- root shape
Q122
b- implant would not be placed in the optimum position
Q123
a- palatal implant position enhance emergence profile of the crown
Q124
e- all of the above
Q125
b- abutment flaring widely above implant
Q126
e- a&d
Prosthetic 199
Q127
e- all of the above
Q128
c- multiple unite implants
Q129
e- a&b
Q130
e- b&c
Q131
e- all of the above
Q132
e- all of the above
Q133
e- all of the above
Q134
a- cemented at the level of abutment while screw is at the level of implant
Q135
e- all of the above
Q136
e- all of the above
Q137
d- decrease stress to the underlying abutment
Q138
c- related occlusion
Q139
b- implant- bone relation
Q140
c- compensating curve
Q141
a- group of function occlusion
Q142
Q143
d- group of function
Q144
e- all of the above
Q145
Q146
c- buccal cusp should be above the implant for better emergence profile
Q147
d- wider occlusal table
Q148
e- all of the above
Q149
e- a&c
Q150
c- during protrusive movement posterior teeth should be separate away and only anterior
teeth come in contact
Q151
a- increase the overjet and decrease the overbite
Q152
d- impede the flexion of the mid- palatal suture, that impedes the flexion of the other
cranial bones (cranial rhythm)
Q153
c- to avoid stress on implant on the early stage
Q154
e- c&d
Q155
e- all of the above
Q156
e- a&d
Prosthetic 201
Q157
Q158
b- rough surface of the cement that retained bacteria
Q159
e- c&d
Q160
d- can scan the transmucosal abutment part
Q161
e- a&c
Q162
b- poor oral hygiene patient
Q163
a- patient habit
Q164
e- a&d
Q165
b- more coronaly placed junctional epithelium
Q166
a- 10 to 15 minutes
Q167
e- a&d
Q168
e- all of the above
Q169
c- serve for several weeks
Q170
b- 6mm
Q171
d- 2mm
Q172
a- both sentences are correct
Q173
e- b&c
Q174
b- avoid excessive bar bulk under the anterior maxilla
Q175
b- when the implant are placed more palatal
Q176
e- a&c
Q177
c- less stress on the crestal bone
Q178
a- probably integrate only zygomatic bone and not the palatal bone
Q179
b- narrow implant
REFERENCES
Abrahamsson I., Berglundh T. & Lindhe J. The mucosal barrier following abutment
dis/reconnection. An experimental study in dogs. J Clin Periodontol 1997 24, 568–572.
Becker K, Mihatovic I, Golubovic V, Schwarz F Impact of abutment material and dis-/re-
connection on soft and hard tissue changes at implants with platform-switching. J Clin
Periodontol 2012; 39:774–780.
Becker W, Becker BE. the replacement of maxillary and mandibular molars with single
endosseous implant restorations: A retrospective study. J Prosthet Dent. 1995;74:51– 5.
Berglundh T, Lindhe J, Marinello C, Ericsson I, Liljenberg B. Soft tissue reaction to de novo
plaque formation on implants and teeth. An experimental study in the dog. Clin Oral
Implants Res 1992;3:184.
Blanes RJ, Bernard JP, Blanes ZM, Belser UC. A 10-year prospective study of ITI dental
implants placed in the posterior region. II: Influence of the crown-to-implant ratio and
different prosthetic treatment modalities on crestal bone loss. Clin Oral Implants Res
2007;18:707–14.
Burns J, Palmer R, Howe L, Wilson R. Accuracy of open tray implant impressions: an in
vitro comparison of stock versus custom trays. J Prosthet Dent. 2003;89:250–5.
Prosthetic 203
Buser D, Martin W, Belser UC Optimizing esthetics for implant restorations in the anterior
maxilla: anatomic and surgical considerations. Inter J Oral Maxilo Impl 2004;19
(Suppl.): 43–61.
Carlsson GE. Dental occlusion: modern concepts and their application in implant
prosthodontics. Odontology 2009;97:8–17.
Cehreli MC, Akça K, Iplikçioğlu H Force transmission of one- and two-piece morse-taper
oral implants: a nonlinear finite element analysis. Clin Oral Implants Res. 2004;15:481–
9.
Charruel S, Perez C, Foti B, et al. Parameters for gingival contour assessment. J Periodontol
2008;79:795–801.
Chu SJ, Tan JH, Stappert CF, Tarnow DP. Gingival Zenith Positions and Levels of the
Maxillary Anterior Dentition. J Esthet Restor Dent. 2009;21:113–20.
Dao TT, Lund JP Lavigne GJ Comparison of pain and quality of life in bruxers and patients
with myofascial pain of the masticatory muscles. J Orofac Pain 1994;8:350–6.
De Boever AL, Keersmaekers K, Vanmaele G, Kerschbaum T, Theuniers G, De Boever JA.
Prosthetic complications in fixed endosseous implant-borne reconstructions after an
observations period of at least 40 months. J Oral Rehabil 2006;33:833–9.
Ekelund JA, Lindquist LW, Carlsson GE, Jemt T.A 15-year study of osseointegrated implant
in the treatment of edentulous jaw. Int J Prosthodont. 2003;16:602–8.
Eric Rompen, Nicolas Raepsaet, Olivier Domken, Bernard Touati, Eric Van Dooren Soft
tissue stability at the facial aspect of gingivally converging abutments in the esthetic
zone: A pilot clinical study. J Prosthet Dent 2007; 97: S119–S125.
Goulet JP, Lund JP, Montplaisir J, et al. Daily clenching, nocturnal bruxism, and stress and
their association with TMD symptoms. J Orofac Pain. 1993;7:89.
Hattori Y, Satoh C, Seki S, Watanabe Y, Ogino Y, Watanabe M. Occlusal and TMJ loads in
subjects with experimentally shortened dental arches. J Dent Res 2003;82:532–6.
Hillam DG. Stresses in the periodontal ligament. J Periodontal Res 1973;8:51–6.
Hormia, M. & Könönen, M. Immunolocalization of fibronectin and vitronectin receptors in
human gingival fibroblasts spreading on titanium surfaces. J Periodontal Res
1994;29:146–152.
Ivanis T, Zivko-Babic J, Lazic B, Panduric J Dimensional Stability of Elastomeric Impression
Materials Disinfected in a Solution of 0.5% Chlorhexidine Gluconate and Alcohol Acta
Stomatol Croat 2000;34:11–14.
2006;201:77–89.
Johansson A, Omar R, Carlsson GE. Bruxism and prosthetic treatment: a critical review. J
Prosthodont Res 2011;55: 127–36.
Judy Chia-Chun Yuan, Cortino Sukotjo, Occlusion for implant-supported fixed dental
prostheses in partially edentulous patients: a literature review and current concepts. J
Periodontal Implant Sci 2013;43:51–57.
Jung, R. E., Holderegger, C., Sailer, I., Khraisat, A., Suter, A. & Hämmerle, C. H. The effect
of all-ceramic and porcelain-fused-tometal restorations on marginal peri-implant soft
tissue color: a randomized controlled clinical trial. Inter J of Periodontics & Rest Dent
2008;28:357–365.
Kim Y, Oh TJ, Misch CE, Wang HL. Occlusal considerations in implant therapy: clinical
guidelines with biomechanical rationale. Clin Oral Implants Res 2005;16:26–35.
Kim Y, Oh TJ, Misch CE, Wang HL. Occlusal considerations in implant therapy: clinical
guidelines with biomechanical rationale. Clin Oral Implants Res 2005;16:26–35.
Kinsel RP, Lin D. Retrospective analysis of porcelain failures of metal ceramic crowns and
fixed partial dentures supported by 729 implants in 152 patients: patient-specific and
implant-specific predictors of ceramic failure. J Prosthet Dent 2009;101:388–94.
Könönen, M., Hormia, M., Kivilahti, J., Hautaniemi, J. & Thesleff, I. Effect of surface
processing on the attachment, orientation, and proliferation of human gingival fibroblasts
on titanium. J Biomed Materials Res 1992;26:1325–1341.
Kois JC Predictable single-tooth peri-implant esthetics: five diagnostic keys Compend Contin
Educ Dent. 2004;25:895–6.
Korsch M, Obst U, Walther W. Cement-associated periimplantitis: a retrospective clinical
observational study of fixed implant-supported restorations using a methacrylate cement.
Clin Oral Impl Res 25, 2014, 797–802.
Lang NP, Berglundh T, Heitz-Mayfield LJ, Pjetursson BE, Salvi GE, Sanz M. Consensus
statements and recommended clinical procedures regarding implant survival and
complications. Int J Oral Maxillofac Implants 2004;19(Suppl.):150–154.
Lee SJ, Gallucci GO. Digital vs. conventional implant impressions: efficiency outcomes. Clin
Oral Impl Res. 2013;24:111–115.
Linkevicius T, Vindasiute E, Puisys A, Linkeviciene L, Maslova N, Puriene A. The influence
of the cementation margin position on the amount of undetected cement. A prospective
clinical study. Clin Oral Implants Res. 24, 2013, 71–76.
Micheal s. block. Color Atlas of Dental Implant Surgery, 3rd Edition Saunders; Missouri,
2010.
Misch CE. Principles of cemented-retained fixed implant prosthodontics. In Misch CE, ed.
Dental implant prosthetics.3rd ed. Maryland Heights, Mo: Mosby; 2005:419.
Nissan J, Narobai D, Gross O, Ghelfan O& Chaushu G. Long-term outcome of cemented
versus screw-retained implant-supported partial restorations. Int J Oral & Maxillofac
Implants 2011;26:1102–1107.
Okeson JP The effects of hard and soft occlusal splints on nocturnal bruxism. J Am Dent
Assoc 1987;114:788–91.
Parfitt GJ. Measurement of the physiological mobility of individual teeth in an axial direction.
J Dent Res 1960;39: 608–18.
Pontoriero R, Tonelli MP, Carnevale G, Mombelli A, Nyman SR, Lang NP. Experimentally
induced periimplant mucositis. A clinical study in humans. Clin Oral Implants Res
1994;5:254–259.
Ramer N, Wadhwani C, Kim A, Hershman D Histologic Findings within Peri-implant Soft
Tissue in Failed Implants Secondary to Excess Cement Report of Two Cases and Review
of Literature N Y State. Dent J 2014;80:43–6.
Scarano A, Piattelli M, Caputi S, Favero G A & Piattelli A. Bacterial adhesion on
commercially pure titanium and zirconium oxide disks: an in vivo human study. J
Periodontol 2004;75:292–296.
Schulte W. Implants and the periodontium. Int Dent J 1995;45:16–26.
Sekine H, Komiyama Y, Potta H, Yoshida K. Mobility characteristics and tactile sensitivity
of osseointegrated fixture-supporting systems. In: van Steenberghe D, Albrektsson T,
Branemark PI, Henry PJ, Holt R, Liden G, editors. Tissue integration in oral and
maxillofacial reconstruction. Amsterdam: Excerpta Medica; 1986:326–32.
Prosthetic 205
Shefter, G. & McFall, W Occlusal relations and periodontal status in human adults. J
Periodontol 1984;55: 368–374.
Skalak R. Biomechanical considerations in osseointegrated prostheses. J Prosthet Dent
1983;49:843–8.
Solnit, G.S. & Schneider, R.L. An alternative to splinting multiple implants: use of the ITI
system. J Prosthodon 1998;7:114–119.
The Role of the Implant Housing in Obtaining Aesthetics: Part 2. Customizing the Peri-
Implant Soft Tissue Smukler H, Castellucci F, Capri D. Practical Procedures Aesth Dent.
2003;15:487– 490.
Touati B, Rompen E, van Dooren E. A new concept for optimizing soft tissue integration.
Pract Proced Aesthet Dent 2005;17:711–715.
Chapter 10
MAINTENANCE
1- Failing implant are characterized clinically by:

a- increased mobility, periimplant radioluceny, probing depth more than 6 mm
b- increased mobility, periimplant radioluceny, probing depth more than 4 mm
c- increased mobility, peri- implant gingival swelling, probing depth more than 5 mm
d- increased mobility, sinus discharge, probing depth more than 5 mm
2- Long- term studies have shown that peri- implantitis occurs more frequently in patients
who are:
a-periodontally compromised
b-diabetic
c-cigarette smokers
d-implant covered with non- keratinized mucosa
e-a&c
3- The non invasive method to detect crestal bone resorption on lingual and buccal side
of the implant by using:
a- probing
b- periapical radiograph
c- resonance frequency analysis
d- surgical exposure
4- The annual bone loss after the first year of implant function should be no more than:
a- 0.05mm
b- 0.2mm
c- 0.5mm
d- 0.8mm
e- 1mm
5- The drawback of placing implant too labial in the upper anterior area (aesthetic zone),
all true except:
a- labial bone resorption
b- gingival recession
c- metal show and darkening the gingival margin
d- ridge lab crown needed
e- crown limited to cemented crown
6- The disadvantage of hydroxyapatite coating surface implant is:

a- surface detachment with high torque implant placement
b- high surface roughness prevent osteoblast attachment
c- surface coating resorption in acidic media
d- functional surface area reduced
e- a&c
7- To avoid scratching and roughening the titanium implant abutment surface, the scaling
instruments should be made of:
a- diamond
b- hard plastic
c- stainless steel
d- titanium
e- b&d
8- Progressive marginal bone loss or ‘Saucerization’ because of:

a- peri- implantitis
b- using wide diameter implant
c- overloading of the implant
d- coronal microthread implant design
e- a&c
9- Implantogingival and dentogingival tissues had a similar reaction to plaque formation,

except:
a- inflammatory cells
b- collagen density
c- density of fibroblasts
d- epithelial proliferation
10- Fistula tract lesions have been found mostly at the level of the implant/abutment
connection, the cause of these lesions is:
a- loose or fractured abutment screw
c- crown decemtation
d- implant failurity
e- b&d
Maintenance 209
11- After one year of loading, implant failure should be attributed to:
a- surgical failure
b- overloading
c- peri- implantitis
d- osseointegration failure to achieve
e- b&c
12- Implant failure that occurs during the first 3–6 months of loading, because of:
a- mechanical loading
b- failure to establish osseointegration
c- surgical cause
d- peri- implant gingivitis
e- a&c
13- Patient education and home care after prosthesis delivery for dentate and edentulous
patient should focus on:
a- hygiene of the natural teeth and/or implant
b- hygiene of the surrounding tissue
c- hygiene of prosthesis
d- all of the above
14- The accuracy of the probing measurement can be affected by:

a- prosthetic design
c- gingival hyperplasia
d- loss of reference point
e- all of the above
15- The purpose of gingival probing during implant follow up is to evaluate:

a- bleeding
b- exudate
c- tissue consistency
d- pocket depth
e- all of the above
16- Which of the following has high percentage of denture related stomatitis:
a- conventional acrylic denture
b- conventional chrome- cobalt denture
c- bar- retained overdenture
d- stud- retained over denture
17- Bar over denture on implant has cleaning difficulty during the maintenance period,
because of:
a- gingival overgrowth under the bar
b- bar roughness
c- lingualized placed bar
d- limited space between implant abutment
e- all of the above
18- Implant need to be removed when the mobility is more than:

a- 0.05mm
b- 0.1mm
c- 0.3mm
d- 0.5mm
19- Pain and patient discomfort with dental implant can be related to:
a- nerve encroachment by implant
b- soft tissue entrapped between the implant body and abutment
c- mobile implant
d- overloaded implant
e- all of the above
20- keratinized mucosa is preferred over non- keratinized mucosa around dental implant
because of:
a- resist abrasion
b- resist gum recession
c- decrease probing depth
d- can fill the interdental papillae
e- all of the above
21- When bone resorption around implant occurs the thick gingival tissue will:
a- form a pocket
b- recessed following the bone
c- will remain stable and healthy
d- over grow
22- Periodontal involved tooth adjacent to dental implant may has adverse effect on the
dental implant through:
a- increase the crown length
b- implant solely loaded
c- infection may spread to the implant
d- all of the above
Maintenance 211
23- The non- surgical therapy for the treatment of peri- implantities may be rendered
ineffective because of:
a- cause damage to the implant surface
b- adverse tissue reaction
c- limit access to infected sites
d- need skill and special instruments
e- all of the above
24- Decontamination methods used to decontaminate the implant surface involved with
peri- implantities, all true except:
a- air- powder abrasion
b- collagen membrane
c- citric- acid application
d- laser therapy
e- peroxide treatment
25- The treatment of choice in peri- implantities case is:

a- open surgery, debridement, bone grafting and collagen membrane
b- laser decontamination
c- conservative debridement (non surgical)
d- open surgery and collagen membrane
26- The type of bacteria in peri- implant lesions are similar to deep periodontal pockets,
but peri- implantitis treatment prognosis is much less predictable, because of:
a- less blood supply
b- unknown anatomy
c- none well- defined surface structure
d- limited access to the site
e- b&c
27- The early signs of peri- implantities (mucositis) is:

a- purulence
b- oedem and bleeding on probing
c- bone loss
e- all of the above
28- Triple therapy is recommended in the case of peri- implant mucosities, which is:
a- mechanical debridement + chlorhexidine (0.12%) irrigation + 2% tetracycline gel,
repeated one times within a two- week period
b- mechanical debridement + chlorhexidine (0.12%) irrigation + 2% minocycline gel,
repeated 4 times within a 4- week period
c- mechanical debridment + chlorhexidine (0.12%) irrigation + 2% tetracycline gel,
repeated three times within a four- week period
d- mechanical debridement + chlorhexidine (0.2%) irrigation + 2% minocycline gel,

repeated 3 times within a two- week period
e- mechanical debridement + chlorhexidine (0.12%) irrigation + 2% minocycline gel,
repeated 3 times within one month period
29- The following should be considered to avoid peri- implant infection and
inflammation:
a- occlusion should be checked and adjusted
b- adequate buccal bone thickness
c- careful use of cement material
d- proper prosthesis design for better patient maintenance
e- all of the above
30- Peri- implantities has many etiological factors one of these is the implant itself, like:
a- implant design
b- implant surface
c- implant position
d- implant annulus
e- all of the above
31- peri- implantities has many etiological factors one of these is the patient himself, like:
a- periodontal disease
b- bone volume
c- bone density
d- soft tissue
e- all of the above
32- peri- implantities has many etiological factors one of these is the foreign body
reaction, like:
a- bioactive implant surface
b- inert implant surface
c- provesional crown
d- excess cement
e- all of the above
CORRECT ANSWERS
Q1
a- increased mobility, periimplant radioluceny, probing depth more than 6 mm
Q2
e- a&c
Maintenance 213
Q3
a- probing
Q4
b- 0.2mm
Q5
d- ridge lab crown needed
Q6
e- a&c
Q7
e- b&d
Q8
e- a&c
Q9
c- density of fibroblasts (there is decreases in the fibroblast density in inflamed
dentogingival tissues, while the density around the implants the same as that found around
healthy implant tissues)
Q10
a- loose or fractured abutment screw
Q11
e- b&c
Q12
b- failure to establish osseointegration
Q13
d- all of the above
Q14
e- all of the above
Q15
e- all of the above
Q16
c- bar- retained overdenture
Q17
a- gingival overgrowth under the bar
Q18
d- 0.5mm
Q19
e- all of the above
Q20
e- all of the above
Q21
a- form a pocket
Q22
d- all of the above
Q23
c- limit access to infected sites
Q24
b- collagen membrane
Q25
a- open surgery, debridement, bone grafting and collagen membrane
Q26
e- b&c
Q27
b- oedem and bleeding on probing
Q28
d- mechanical debridement + chlorhexidine (0.2%) irrigation + 2% minocycline gel,
repeated 3 times within a two- week period
Q29
e- all of the above
Q30
b- implant surface
Q31
e- all of the above
Q32
d- excess cement
Maintenance 215
REFERENCES
Adell R, Lekholm U, Rockler B, Brånemark PI. A 15- year study of osseointegrated implants
in the treatment of the edentulous jaw. Int J Oral Surg 1981;10:387–416.
Albrektsson, T., Zarb, G., Worthington, P. & Eriksson, A.R. The long-term efficacy of
currently used dental implants: a review and proposed criteria of success. Int J Oral
Balshi TJ & Wolfinger GJ. Immediate loading of Bra ˚nemark implants in edentulous
mandibles: a preliminary report. Implant Dent 1997;6:83–88.
Berglundh T, Lindhe J, Marinello C, Ericsson I, Liljenberg B. Soft tissue reaction to de novo
plaque formation on implants and teeth: An experimental study in the dog. Clin Oral
Bragger U. Radiographic parameters for the evaluation of peri-implant tissues. J Periodontol
2000;4:87–97.
Claffey N, Clarke E, Polyzois I, Renvert S Surgical treatment of peri-impantitis. J Clin
Periodontol 2008;35(Suppl. 8):316–332.
Esposito M, Hirsch JM, Lekholm U & Thomsen P. Biological factors contributing to failures
of osseointegrated oral implants. (I). Success criteria and epidemiology. Europ J Oral
Scien 1998;106: 527–551.
Fox S C, Moriarty J D, Kusy R P. The effects of scaling a titanium implant surface with metal
and plastic instruments: an in vitro study. J Periodontol 1990;61: 485–490.
Lang NP, Bragger U, Walther D, Beamer B, Kornman KS. Ligature-induced peri-implant
infection in cynomolgus monkeys. I. Clinical and radiographic findings. Clin Oral
P. Coulthard, M. Esposito, M. Slater, H. V. Worthington; Series Editor E. J. Kay Prevention.
Part 5: Preventive strategies for patients requiring osseointegrated oral implant treatment.
British Dent J 2003;195:187–194.
Renvert S, Roos-Jansa’ker AM, Claffey Non surgical treatment of peri-implant mucositits
and peri-implantitis: a literature review. J Clin Periodontol 2008;35:305–315.
Roccuzzo M, Bonino F, Bonino L, Dalmasso P Surgical therapy of peri-implantitis lesions by
means of a bovine-derived xenograft: comparative results of a prospective study on two
different implant surfaces. J Clin Periodontol 2011;38:738–745.
Szmukler-Moncler S, Piattelli A, Favero JA, Dubruille JH Considerations preliminary to the
application of early and immediate loading protocols in implant dentistry. Clin Oral
Implants Res 2006;11: 12–25.
Wohlfahrt JC, Aass AM, Ronold HJ & Lyngstadaas SP Micro CT and human histological
analysis of a peri-implant osseous defect grafted with porous titanium granules: a case
report. Int J Oral Maxillofaci Implants 2011;26:9 –14.
INDEX
A B
acidic, 186, 208 bacteria, 58, 92, 118, 144, 182, 186, 201, 211
adaptation, 78, 114, 132, 170, 172, 186 bacteriostatic, 51, 57, 62
adhesion, 118, 171, 204 barium, 189
adipose tissue, 20, 128 basal lamina, 32
adrenal crisis, 91 bicuspid, 5, 11, 13, 163, 192
adrenaline, 29, 58 bilateral, 162, 184
adverse effects, 73, 119 biocompatibility, 70, 118
aesthetic(s), 87, 113, 122, 125, 142, 152, 154, 160, biocompatible materials, 187
170, 171, 185, 203, 208 bleaching, 125
alkaline phosphatase, 71, 76, 92, 93, 96 bleeding, 3, 4, 9, 11, 35, 36, 39, 44, 52, 55, 65, 70,
allergic reaction, 56, 100 73, 92, 102, 110, 113, 119, 134, 138, 186, 209,
alveolar ridge, 78, 99, 102, 128, 134, 150, 153, 166 211, 214
alveolus, 34, 44 blood clot, 71, 114, 119, 143
anaphylactic shock, 56 blood dyscrasias, 55, 56
anastomosis, 34 blood flow, 29
anatomy, 17, 41, 82, 96, 120, 124, 161, 182, 211 blood supply, 4, 6, 8, 17, 22, 23, 31, 34, 40, 41, 72,
anchorage, 152 101, 113, 114, 124, 129, 130, 133, 143, 211
anemia, 29 blood vessels, 5, 13, 33, 35, 38, 39, 43, 46, 102, 113,
angiogenesis, 35, 36, 44, 114, 117, 119 114, 117, 143
angulation, 6, 38, 73, 81, 82, 84, 86, 103, 106, 107, bone cells, 33, 43
110, 115, 122, 125, 140, 160, 164, 168, 171, 180, bone form, 23, 34, 44, 48, 58, 66, 67, 68, 74, 78, 79,
182, 183, 190, 200, 209 83, 92, 103, 106, 119, 121, 130, 139, 149, 157
anoxia, 90 bone growth, 78, 91, 115
antacids, 53, 54, 55, 57, 60 bone marrow, 8, 29, 40, 48, 119
antibiotic, 52, 54, 56, 57, 60, 109, 116, 141 bone mass, 72
anticoagulant, 53, 57, 91 bone resorption, 23, 24, 26, 37, 39, 45, 58, 66, 70,
anticonvulsant, 54, 55, 56, 57 73, 74, 79, 85, 92, 93, 99, 106, 107, 108, 115,
antidepressant(s), 53, 57, 58, 90 118, 121, 123, 126, 133, 137, 140, 144, 145, 148,
antrum, 82, 122 152, 159, 162, 163, 166, 172, 179, 182, 184, 196,
apex, 85, 87, 102, 103, 110, 137, 139 207, 208, 210
aplastic anemia, 29 bone volume, 99, 106, 135, 212
apoptosis, 58, 62 brittleness, 118
artery, 3, 4, 6, 8, 9, 13, 14, 15, 16, 29, 95, 102, 127, bruxism, 90, 169, 194, 203, 204
128, 134
atrophy, 23, 29, 56
218 Index
165, 166, 168, 171, 172, 173, 174, 175, 176, 177,
C 178, 179, 180, 181, 182, 183, 184, 185, 186, 187,
188, 190, 191, 195, 197, 198, 200, 202, 204, 208,
caffeine, 54
210, 212, 213
calcitonin, 33, 34
crystals, 24, 33
calcium, 54, 55, 71, 76, 93
calcium channel blocker, 54, 55
canals, 6, 14 D
candida, 56
candidiasis, 56 debridement, 211, 212, 214
carbamazepine, 52, 54 decontamination, 211
carcinoma, 66 decortication, 154
cardiac arrhythmia, 58 defects, 130, 136, 154
cardiovascular disease, 19 deficiencies, 120
caries, 93 degradation, 34, 119
cartilage, 77, 90 dehiscence, 92, 105, 109, 112, 113, 116, 122, 125,
cavernous sinus thrombosis, 89 129, 131, 133, 150, 163
cephalosporin, 51, 59, 62 dehydration, 22, 27, 123
ceramic, 36, 203, 204 dental implants, 31, 36, 41, 48, 79, 82, 87, 152, 153,
channel blocker, 53, 54, 55 157, 161, 185, 202, 215
chemical, 73, 77, 79 dentures, 82, 204
chemical properties, 77 depth, 39, 42, 92, 103, 125, 129, 133, 136, 160, 178,
chondrocyte, 32 179, 188, 207, 209, 210, 212
cigarette smokers, 207 derivatives, 32
cleaning, 160, 210 destruction, 58, 92
clinical application, 48, 153 detachment, 3, 4, 13, 208
closure, 9, 21, 66, 101, 105, 109, 115, 117, 123, 124, deviation, 131, 170
125, 126, 129, 130, 132, 133, 144, 150, 173, 176 diabetes, 136
cobalt, 209 diabetic patients, 90
coffee, 54 diaphragm, 11, 15
collagen, 22, 24, 27, 31, 32, 33, 34, 35, 36, 39, 40, discomfort, 133, 185, 210
41, 42, 43, 44, 58, 68, 92, 104, 105, 107, 109, diseases, 78, 90, 101, 135
114, 117, 118, 119, 136, 139, 157, 208, 211, 214 disinfection, 116
comparative analysis, 49 displacement, 134, 161
complications, 121, 126, 153, 157, 162, 172, 186, distribution, 16, 190
203, 204 dosage, 55, 58, 66, 81
composition, 22, 41 drainage, 5
compression, 59, 109, 130, 167 drug dependence, 55
computed tomography, 16 drug interaction, 52, 54, 55, 56, 57, 61
condensation, 105, 135, 151, 171 drug therapy, 55
connective tissue, 31, 32, 33, 35, 36, 38, 39, 42, 43, drugs, 52, 53, 54, 57, 58, 62, 89
44, 47, 70, 72, 75, 114, 116, 117, 120, 128, 129, duodenum, 57
136, 144, 151 dysplasia, 58
consumption, 90, 94
contamination, 71, 76, 92, 107, 140
contour, 41, 49, 78, 130, 153, 155, 183, 203 E
coronary artery disease, 95
cortical bone, 8, 22, 23, 29, 41, 48, 72, 83, 110, 117, ecchymosis, 55, 134
119, 130, 144, 155, 190 ectoderm, 40
covering, 103, 139 edema, 5, 59, 89, 90, 133
cranial nerve, 89, 94 enamel, 34, 58, 103, 124, 137
cricothyroid membrane, 90, 94 endocrine, 90
crown(s), 40, 48, 73, 77, 115, 116, 121, 120, 122, endoderm, 40
125, 128, 147, 148, 159, 160, 161, 162, 163, 164, endothelial cells, 39, 69
Index 219
enlargement, 4, 13, 56, 115, 152

epidemiology, 215 G
epiglottis, 8
gingival, 22, 23, 26, 29, 38, 42, 45, 49, 55, 56, 61,
epilepsy, 51
72, 73, 78, 102, 103, 105, 106, 108, 110, 113,
epinephrine, 52, 57
115, 116, 117, 120, 121, 122, 123, 124, 128, 130,
epithelial cells, 32
132, 133, 134, 136, 137, 144, 145, 146, 151, 154,
epithelium, 31, 32, 35, 37, 39, 40, 41, 42, 43, 46, 47,
155, 157, 160, 163, 164, 168, 170, 173, 175, 176,
72, 117, 144, 187, 201
178, 179, 180, 184, 188, 192, 203, 204, 207, 208,
Epstein-Barr virus, 96
209, 210, 211, 214
estrogen, 34
gingival overgrowth, 105, 210, 214
exclusion, 117, 144
gingivitis, 96, 136, 160, 209
exophthalmos, 89
gland, 11, 20, 22
exposure, 30, 82, 84, 105, 106, 109, 116, 126, 133,
glossopharyngeal nerve, 8
137, 140, 147, 150, 190, 207
glucagon, 91
external oblique, 111, 167
glucose, 91, 123, 127
extracellular matrix, 42, 78
glycosaminoglycans, 29
extraction, 4, 20, 26, 31, 35, 42, 43, 47, 49, 72, 99,
gonorrhea, 57
101, 103, 108, 115, 117, 127, 136, 137, 153, 155,
graft healing, 111
156, 164, 174, 179, 192
granules, 153, 215
extrusion, 120, 145
growth, 65, 69, 78, 79, 91, 113, 115, 117, 118, 160,
exudate, 209
175, 178
growth factor, 65, 69, 79, 117
F
fabrication, 85, 168, 169, 171 H

facial nerve, 8, 24, 89
haemostasis, 70, 75
fascia, 15
haemostatic agent, 102, 123
fibers, 7, 8, 9, 22, 24, 27, 31, 34, 42, 43
harvesting, 128, 129, 130
fibrin, 117, 144
head and neck cancer, 66
fibroblast growth factor, 79
headache, 169, 185
fibroblasts, 40, 208, 213
healing, 26, 35, 36, 38, 39, 41, 42, 49, 55, 59, 62, 65,
fibrous dysplasia, 58
66, 73, 77, 79, 99, 102, 103, 105, 106, 107, 109,
fibrous tissue, 32, 33, 66, 92, 134
111, 113, 114, 115, 116, 119, 122, 123, 126, 129,
first molar, 3, 10, 12, 21, 41, 127, 173, 187
130, 131, 132, 134, 136, 138, 140, 143, 148, 153,
fitness, 165, 166, 171, 175, 181
154, 155, 156, 170, 188
fixation, 113, 117
hematoma, 3, 4
flapless surgery, 127, 153
hematopoietic stem cells, 40
fluid, 90, 119
hemophilia, 52
food products, 53, 54
hemostasis, 35, 36, 44, 168
foramen, 3, 5, 6, 12, 13, 16, 19, 20, 23, 26, 110, 111,
hepatitis, 63
127, 128, 129, 135, 141, 148, 177
histology, 34, 44
force, 20, 21, 25, 28, 34, 72, 76, 107, 112, 140, 161,
histone, 78
162, 173, 177, 178, 181
HIV, 63, 102
formaldehyde, 123
hormone, 34, 57
formation, 3, 23, 32, 34, 35, 36, 37, 38, 39, 40, 42,
hydrocortisone, 91, 94
44, 45, 48, 58, 63, 66, 67, 68, 70, 73, 74, 75, 78,
hydrolysis, 119
79, 83, 87, 92, 103, 106, 108, 110, 113, 118, 119,
hydrophilicity, 79, 169
120, 121, 130, 134, 139, 141, 149, 157, 202, 208,
hydroxyapatite, 65, 68, 77, 208
215
hygiene, 109, 140, 141, 160, 161, 163, 166, 178,
fractures, 32, 129, 189
183, 187, 201, 209
hyoid, 7, 14, 21
hyperplasia, 55, 56, 61, 209
220 Index
hypertension, 55
hyperthyroidism, 83 L
hypoglossal nerve, 8, 12
larynx, 10
hypoglycemia, 90
lead, 19, 23, 26, 38, 40, 66, 71, 90, 99, 102, 112,
hypotension, 55, 56
134, 137, 151, 185, 186, 189
leakage, 90, 166
I lesions, 87, 208, 211, 215
leukocytes, 119, 144
ibuprofen, 54, 58, 62 levator, 10
iliac crest, 118, 132, 144 ligament, 5, 9, 34, 72, 79, 203
image, 82, 84, 85, 86, 87 local anesthesia, 52
immune response, 42, 118, 119 lower lip, 8, 11, 129
immune system, 70 lymphocytes, 92
implant dentistry, ix, x, 106, 154, 155, 163, 165, 215
implant diameter, 109, 127, 159, 188
implant length, 48, 109, 115, 161, 191 M
implant placement, 4, 5, 12, 16, 26, 35, 37, 38, 45,
macrophages, 92, 119, 144
47, 48, 67, 101, 102, 103, 104, 105, 106, 107,
malignancy, 59
108, 110, 112, 113, 115, 117, 121, 125, 127, 128,
malocclusion, 20
131, 132, 133, 135, 136, 137, 139, 140, 143, 151,
mandible, 3, 4, 6, 7, 9, 16, 19, 20, 21, 22, 23, 24, 26,
153, 154, 156, 173, 179, 180, 188, 208
27, 29, 35, 82, 106, 110, 127, 128, 130, 132, 152,
implantology, x, 81, 152
154, 157, 173, 176
implants, 19, 31, 36, 39, 41, 48, 49, 70, 72, 77, 79,
mapping, 123, 152
82, 87, 104, 110, 112, 113, 122, 124, 125, 131,
marrow, 6, 8, 29, 40, 48, 117, 119
135, 145, 147, 152, 153, 154, 155, 156, 157, 160,
mass loss, 72
161, 162, 165, 172, 180, 183, 184, 185, 186, 187,
masseter, 21, 176, 197
189, 190, 191, 199, 202, 203, 204, 205, 213, 215
material surface, 68
impression materials, 186
materials, 48, 155, 156, 161, 186, 187
in vitro, 29, 96, 202, 215
matrix, 33, 35, 36, 41, 42, 43, 44, 65, 68, 69, 71, 75,
in vivo, 77, 204
77, 78, 79
incidence, 105, 115, 130, 164
maxilla, 20, 21, 35, 48, 66, 110, 123, 125, 126, 127,
incisor(s), 3, 5, 11, 13, 16, 27, 29, 30, 41, 78, 105,
128, 131, 135, 148, 152, 153, 177, 189, 202, 203
109, 116, 119, 122, 127, 129, 145, 149, 163, 164,
maxillary sinus, 6, 15, 16, 17, 19, 25, 59, 84, 90, 101,
169, 170, 172, 177, 183, 185, 187, 189, 192, 195,
102, 103, 104, 105, 110, 115, 120, 121, 122, 126,
197
127, 128, 134, 135, 137, 139, 147, 148, 151, 152,
infection, 11, 59, 73, 82, 91, 94, 96, 101, 102, 103,
155, 157
105, 106, 107, 110, 112, 113, 117, 140, 186, 210,
measurement, 16, 30, 152, 169, 209
212, 215
mechanical properties, 22
inflammation, 39, 70, 75, 113, 119, 122, 186, 212
medical, 128, 136, 187
inflammatory cells, 208
melanin, 35
inhibitor, 53, 138
membranes, 8, 119, 152, 154, 157
injury, 4, 5, 37, 92, 95, 111
mesenchymal stem cells, 40
insertion, 19, 35, 131, 181
mesoderm, 40
insulin, 57, 90
metabolism, 34, 78
integration, 49, 72, 79, 186, 204, 205
microcirculation, 16
interface, 48, 77
microhardness, 48
internal oblique, 167
microscopy, 49, 78
iron, 53
microspheres, 16
irrigation, 106, 107, 108, 109, 116, 127, 140, 141,
migration, 32, 42, 47, 89, 118, 130, 131
211, 212, 214
mineralization, 23, 35, 36, 44, 55, 61, 68, 71, 76, 77,
isotonic solution, 71
93, 123
modelling, 34, 35
Index 221
modulus, 23
monoamine oxidase inhibitors, 53 P
morbidity, 111, 128, 152
pain, 5, 7, 52, 59, 65, 89, 113, 116, 119, 165, 169,
morphology, 81, 161
172, 185, 186, 203
morphometric, 77
palate, 8, 9, 10, 15, 82, 86, 128, 166, 167
mouth ulcers, 55
parallel, 6, 14, 31, 34, 42, 43, 104, 123, 125, 126,
mucosa, 4, 6, 8, 11, 14, 29, 35, 39, 40, 46, 47, 49, 73,
147
100, 123, 128, 132, 133, 134, 148, 150, 154, 167,
parallelism, 82, 179
185, 194, 207, 210
paralysis, 89
mucous membranes, 8
parathyroid hormone, 34
multiple myeloma, 58
parotid, 22, 27
muscle relaxant, 54, 57
pathogens, 92
muscle strength, 25
pathology, 186
muscles, 7, 8, 10, 21, 24, 27, 203
pathway, 93, 95, 134
muscular tissue, 5
PDL, 34
myocardial infarction, 91
pellicle, 58
penicillin, 51, 54
N peptic ulcer, 57
perforation, 9, 11, 19, 30, 82, 104, 114, 115, 119,
neck cancer, 66 134, 152, 155, 179, 185
necrosis, 37, 38, 70, 79, 104 perfusion, 73, 123
nerve, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 16, 17, peri-implant soft tissue, 49, 203
24, 42, 58, 59, 62, 65, 74, 89, 94, 103, 108, 111, periodontal, x, 5, 6, 29, 34, 48, 49, 72, 73, 76, 79, 82,
112, 127, 128, 129, 134, 135, 137, 141, 150, 210 83, 86, 92, 93, 120, 121, 136, 154, 155, 157, 186,
nerve fibers, 9, 24 187, 203, 205, 211, 212
neuralgia, 51, 89 periodontal disease, 93, 187, 212
neurogenesis, 112 periodontitis, 78
neuropathy, 96 periosteum, 4, 6, 13, 39, 40, 42, 91, 106, 128, 130,
neuropraxia, 112 131, 132, 133, 134, 148
non-smokers, 29 pharmaceutical, 54, 59
NSAIDs, 52, 54, 56, 57 pharynx, 10
nutrition, 72 phenotypes, 26
philtrum, 179
phosphate, 171
O photosensitivity, 55
physiology, 78
obstruction, 90 placenta, 56, 61
occlusion, 19, 20, 125, 162, 163, 164, 169, 173, 174, plaque, 39, 58, 92, 109, 138, 141, 202, 208, 215
182, 183, 184, 185, 191, 192, 199, 203, 212 plasticity, 34
oedema, 3, 113, 114, 122, 134 platelets, 69
oral cavity, 22, 24, 73, 92, 109, 119, 144 platysma, 4
orthostatic hypotension, 55, 56 plexus, 4, 5, 6, 10, 12, 16
osteogenesis, 67 pneumonia, 92
osteomyelitis, 83, 91 polyether, 171
osteonectin, 71 polymer, 119
osteoporosis, 29, 58 polyp, 103
osteotomy, 17, 103, 105, 106, 122, 126, 127, 129, polypeptides, 70
131, 148, 156, 166, 179 polystyrene, 35
precursor cells, 67, 68, 74
premolar, 3, 4, 10, 11, 15, 16, 27, 29, 41, 47, 110,
114, 172, 173, 177, 183, 185, 195
preservation, 47, 78, 99, 101, 105, 114, 117, 118,
120, 135, 143, 144, 153, 156
222 Index
preservative, 113, 142 side effects, 55, 56, 59

progenitor cells, 114, 119, 143 signalling, 32, 68, 75
prognosis, 38, 152, 187, 211 signals, 65
proliferation, 35, 36, 44, 70, 75, 204, 208 signs, 169, 211
prostheses, 19, 85, 110, 115, 116, 120, 127, 133, sinuses, 83, 84
161, 162, 163, 164, 165, 167, 170, 172, 173, 174, sinusitis, 92, 131, 155
181, 182, 183, 184, 185, 186, 189, 195, 203, 205, smoking, 22, 23, 27, 73
209, 212 solution, 71, 127, 183
proteins, 33, 68, 77 splinting, 161, 205
PTFE, 101, 118, 152 sprouting, 113, 143
ptosis, 130 stability, 12, 41, 48, 65, 102, 104, 106, 107, 108,
puberty, 115 116, 117, 121, 122, 126, 130, 135, 139, 141, 144,
149, 151, 152, 163, 165, 170, 184, 195, 203
stabilization, 101, 132
R stem cells, 40
stent, 85, 103, 131
radiation, 66, 81, 85 sternocleidomastoid, 25, 28
radiopaque, 83, 189 sternum, 118
radiotherapy, 66, 67, 79, 90 stimulation, 29, 65, 79, 111, 117
receptors, 7, 8, 56, 203 stock, 162, 168, 183, 191, 202
reconstruction, 78, 132, 156, 157, 204 stomatitis, 55, 56, 209
recovery, 112 stress, 21, 23, 34, 66, 72, 90, 109, 112, 113, 125,
regenerate, 65, 118, 128 163, 165, 166, 172, 175, 177, 182, 185, 190, 197,
regeneration, 65, 78, 152, 154, 155, 157 199, 200, 202, 203
rehabilitation, 63, 77, 182 structure, 10, 11, 17, 29, 72, 124, 133, 135, 137, 165,
remodelling, 23, 28, 70, 72, 75, 95, 123, 152 168, 175, 178, 211
repair, 32, 77 sulfate, 55, 189
resistance, 70, 134, 171, 186 surface area, 85, 114, 208
restoration, 73, 135, 162, 170, 178, 189 surface energy, 79
rheumatoid arthritis, 29 surface reaction, 79
rhinitis, 59 surface reactions, 79
risk, 19, 91, 102, 118, 128, 161, 165, 177, 181 surface structure, 79, 211
risk factors, 161 surface treatment, 48
root(s), 9, 11, 15, 48, 83, 87, 107, 110, 118, 120, surgical removal, 136
125, 129, 134, 136, 137, 140, 145, 147, 148, 151, surgical technique, 128, 131
153, 161, 179, 198 surgical techniques, 128
suture, 100, 101, 102, 104, 109, 112, 113, 125, 132,
S 133, 134, 138, 141, 150, 156, 185, 200
symptoms, 90, 165, 169, 185, 203
salivary gland, 20, 22 syndrome, 37, 57, 90
scaling, 116, 208, 215 syphilis, 57
scar tissue, 122, 146
sclerosis, 34, 83
T
second molar, 3, 125, 163, 187
secretion, 22, 56, 58, 93 T cells, 138
sedative, 57 techniques, 48, 67, 68, 74, 78, 87, 99, 128, 153, 154,
sensation, 9, 72 157
sensitivity, 204 teeth, 3, 5, 6, 7, 11, 12, 20, 21, 25, 29, 31, 34, 37, 38,
septum, 82, 100 39, 41, 42, 48, 55, 72, 73, 76, 81, 82, 83, 86, 89,
serum, 69, 75, 78, 93 93, 103, 107, 111, 113, 116, 118, 119, 120, 121,
shape, 26, 29, 41, 73, 76, 89, 115, 120, 123, 137, 136, 137, 139, 140, 145, 151, 160, 161, 163, 164,
164, 165, 171, 175, 179, 184, 185, 192, 198 169, 173, 174, 177, 178, 182, 183, 184, 185, 186,
shear, 72, 76, 107, 140
Index 223
187, 189, 191, 192, 194, 196, 200, 202, 204, 209,
215 U
tensile strength, 100
ulcer, 55, 57, 61
tension, 19, 123, 125, 130, 133, 134, 150
undifferentiated mesenchymal cells, 42, 47
therapy, 55, 58, 63, 72, 78, 152, 203, 204, 211, 215
uvula, 10
thinning, 101, 114
thrombocytopenia, 138
thrombosis, 89, 91 V
tissue, 5, 7, 13, 14, 20, 22, 23, 26, 29, 31, 32, 33, 35,
36, 37, 38, 39, 41, 42, 43, 44, 47, 48, 49, 59, 62, vagus nerve, 24
65, 66, 70, 72, 73, 74, 75, 78, 83, 92, 101, 102, vascular system, 48
103, 105, 106, 107, 108, 109, 110, 112, 113, 114, vascularization, 65, 154
115, 116, 117, 118, 119, 120, 122, 123, 124, 125, vertigo, 55, 111
126, 128, 129, 130, 131, 132, 133, 134, 135, 136, vessels, 5, 6, 13, 29, 33, 35, 38, 39, 43, 46, 102, 113,
138, 141, 142, 143, 144, 146, 151, 152, 153, 154, 114, 117, 134, 143
155, 156, 157, 161, 162, 163, 167, 168, 170, 173, virus infection, 96
175, 178, 180, 182, 184, 185, 186, 187, 190, 191,
192, 193, 202, 203, 205, 209, 210, 211, 212, 215
tissue perfusion, 73 W
titanium, 36, 37, 48, 70, 78, 79, 152, 203, 204, 208,
215 wear, 66, 90
tooth, 3, 4, 12, 20, 26, 31, 38, 39, 41, 42, 49, 58, 72, wide diameter, 103, 104, 108, 112, 115, 208
85, 89, 90, 93, 99, 103, 108, 117, 119, 120, 121, wound dehiscence, 92, 105, 109, 116, 122, 125, 129,
125, 127, 136, 137, 147, 151, 153, 154, 155, 156, 131
160, 161, 162, 170, 173, 177, 178, 179, 185, 187, wound healing, 35, 42, 55, 73, 77, 102, 136, 154
204, 210
torsion, 19, 26
X
toxicity, 134, 150
transduction, 78
xenografts, 118
transformation, 67, 68, 74
transplant, 155
trauma, 6, 9, 58, 59, 102, 134, 153 Z
treatment, 51, 52, 56, 57, 66, 79, 81, 90, 105, 120,
125, 140, 162, 166, 170, 172, 174, 202, 203, 211, zinc, 171
215 zirconia, 116, 161, 178
tricyclic antidepressant, 53, 58 zirconium, 171, 204
trigeminal neuralgia, 51 zygoma, 135
tumor, 79, 100, 101, 137 zygomatic arch, 82, 135
tumor necrosis factor, 79

Implant Dentistry

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Implant Dentistry

Uploaded by

Copyright:

Available Formats

DENTAL SCIENCE, MATERIALS AND TECHNOLOGY

MCQ IN IMPLANT DENTISTRY

Additional books in this series can be found on Nova’s website

Additional e-books in this series can be found on Nova’s website

MCQ IN IMPLANT DENTISTRY

MOHAMMED JASIM AL-JUBOORI

NOTICE TO THE READER

Library of Congress Cataloging-in-Publication Data

Published by Nova Science Publishers, Inc. † New York

Mohammed Jasim Al-Juboori BDS, MSc, AFAAID, FICOI, FADIA

Mohammed Jasim Al-Juboori, BDS, MSc, holds a master’s degree in dental

6- “Witch Chin” is a postoperative complication that occurs when a mucoperiosteal flap

11- The incisive nerve is innervate:

29- Nerve fibers in dentate jawbone are usually limited to:

30- The lingual nerve provides a sensory supply to the:

38- The temporomandibular (lateral) ligament is a thickened ligament on the lateral

39- Nasal bleeding is often due to trauma to the:

45- The greater palatine nerve innervates:

46- A Submandibular space infection can spread into:

49- An anesthesia block to the long buccal nerve will anesthetize:

Malamed SF. Handbook of local anaesthesia. St louis: Mosby, 1986:183–193.

2- During maxillary sinus augmentation, the Schneiderian membrane is susceptible to

3- Perforation of the Schneiderian membrane (mean thickness: 90 μm) occurs at a mean

4- Patients with cardiovascular disease should be treated with:

5- After tooth extraction, all of the following are true except:

7- The resting interocclusal distance (freeway space) can be affected by:

8- Following speech, mastication, or swallowing, the mandible appears to return to:

11- Lateral movement of the mandible is accompanied by lateral translation of the

14- The temporomandibular joint is technically classified as a ginglymoarthrodial

16- The temporomandibular joint is supported by a sling muscle, which comprises

19- Factors affecting salivary composition, such as:

25- Peri- and postoperative gingival blood ﬂow is affected by:

28- Bones respond to physiologic stress by:

31- The maximum tolerable temperature in the mouth ranges from:

39- loudness of sound relates primarily to the:

b- torsion of the mandible distal to the mental foramen

Preiskel H Observations on Bennett movement. Dent Pract Dent Rec 1972;22:179–85.

2- The biological width in cases with natural teeth is measured as:

6- The main components of the basal lamina are:

11- Osteon is a type of cylindrical bone comprising:

13- Osteoblasts are bone- forming cells that can synthesize:

14- Osteoid is:

16- The most important hormones in bone metabolism are:

18- Bone sclerosis means:

20- The increased radiopacity of the lamina dura is due to:

21- Functional plasticity of the alveolar bone is due to:

22- The true periodontal ligament (PDL) blood supply is:

26- Hemidesmosome- like contacts are observed in the following surfaces:

c- bleeding, hemostasis, clot formation, fibrinolysis, formation of a loose connective

29- The important features of the osteoblast include:

35- Burnt bone syndrome refers to:

43- In bone healing, woven bone is formed at a rate of:

44- Pressure necrosis during implant placement will lead to:

45- Pressure necrosis usually occurs when the implant is placed:

53- Aging in the oral mucosa may involve:

60- Large, multinuclear, osteoclast cells originate from:

61- The shape of an interdental papilla is determined by:

62- Keratinized tissue will be minimal in the area of:

Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. he soft tissue

2- Metronidazole is contraindicated in patients who:

4- Patients allergic to penicillin have a 10% chance of cross allergies with:

6- A combination of antibiotics is crucial in the treatment of peri- implantitis, and the

7- The anti- anginal drug nitroglycerin has an onset of action within:

8- Beta adrenergic blocking agents have drug interactions with: